MH Townsend Questions

A client tells the therapist, "I thought I would just die when my husband told me he was leaving me. If I had been a better wife, he wouldn't have fallen in love with another woman. It's all my fault." The therapist asks the client to explore what responsibilities the husband may have in the breakup. What cognitive therapy technique is the therapist using? A. Reattribution B. Role Play C. Decatastrophizing D. Thought Recording.

A

A client who is experiencing a panic attack has just arrived at the emergency department. Which is the priority nursing intervention for this client? A. Stay with the client and reassure of safety. B. Administer a dose of diazepam. C. Leave the client alone in a quiet room so that she can calm down. D. Encourage the client to talk about what triggered the attack.

A

A client with OCD spends many hours each day washing her hands. The most likely reason she washes her hands so much is that it: A. Relieves her anxiety. B. Reduces the probability of infection. C. Gives her a feeling of control over her life. D. Increases her self-concept.

A

A concern with children on long-term therapy with CNS stimulants for ADHD is: A. Addiction B. Weight Gain C. Substance Abuse D. Growth Suppression

A

A law school graduate failing the bar exam and a 15-year-old high school girl not being selected for the cheerleading squad are examples of which of the following? A. Focal stimuli. B. Contextual stimuli. C. Residual stimuli. D. Spatial stimuli.

A

A negative reinforcer: A. Increases the probability that a behavior will recur. B. Decreases the probability that a behavior will recur. C. Has nothing to do with the modifying behavior. D. Always results in unacceptable behavior.

A

A nurse is helping a client in the preparation stage of the Psychological Recovery Model might include which of the following interventions? A. Teach about effects of the illness and how to recognize, monitor, and manage symptoms. B. Help the client identify triggers that cause distress or discomfort. C. Help the client establish a daily maintenance list. D. Listen actively while the client composes his or her personal story.

A

A polysubstance abuser makes the statement, "The green and whites do me good after speed." How might the nurse interpret the statement? A. The client abuses amphetamines and anxiolytics. B. The client abuses alcohol and cocaine. C. The client is psychotic. D. The client abuses narcotics and marijuana.

A

A positive reinforcer: A. Increases the probability that a behavior will recur. B. Decreases the probability that a behavior will recur. C. Has nothing to do with modifying behavior. D. Always results in unacceptable behavior.

A

Amanda's mobile home was destroyed by a tornado. Amanda received only minor injuries, but is experiencing disabling anxiety in the aftermath of the event. What is this type of crisis called? A. Crisis resulting from traumatic stress. B. Maturational/developmental crisis. C. Dispositional crisis. D. Crisis of anticipated life transitions.

A

An individual who is diagnosed with adjustment disorder with disturbance of conduct most likely: A. Violates the rights of others to feel better. B. Expresses symptoms that reveal a high level of anxiety. C. Exhibits severe social isolation and withdrawal. D. Is experiencing a complicated grieving process.

A

Anna, who is 72 years old, is of the age when she may have experienced several losses in a short time. What is this called? A. Bereavement overload B. Normal mourning C. Isolation D. Cultural relativity

A

B.J. has been out with his friends. He is late getting home. He knows his wife will be angry and will yell at him for being late. He stops at the florist and buys a dozen red roses for her. Which of the following behaviors represents negative reinforcement on the part of the wife? A. She meets him at the door, accepts the roses, and says nothing further about his being late. B. She meets him at the door, yelling that he is late, and makes him spend the night on the couch. C. She meets him at the door, expresses delight with the roses, and kisses him on the cheek. D. she meets him at the door and says, "How could you? You know I am allergic to roses!"

A

Brandon, a client on the psychiatric unit, has been diagnosed with schizophrenia. He begins to tel the nurse about how the CIA is looking for him and will kill him if they find him. Brandon's belief is an example of a: A. Delusion of persecution. B. Delusion of reference. C. Delusion of control or influence. D. Delusion of grandeur.

A

Dan begins attendance at AA meetings. Which of the statements by Dan reflects the purpose of this organization? A. "They claim they will help me stay sober." B. "I'll dry out in AA, then I can have a social drink now and then." C. "AA is only for people who have reached the bottom." D. "If I lose my job, AA will help me find another."

A

Dan, who has been admitted to the alcohol rehabilitation unit after being fired for drinking on the job, states to the nurse, "I don't have a problem with alcohol. I can handle my booze better than anyone I know. My boss is a jerk! I haven't missed any more days than coworkers." Which defense mechanism is Dan using? A. Denial B. Projection C. Displacement D. Rationalization

A

Elisa says to the nurse, "I worked as a secretary to put my husband through college, and as soon as he graduated, he left me. I hate him! I hate all men!" Which of the following is an empathetic response by the nurse? A. "You are very angry now. This is a normal response to your loss." B. "I know what you mean. Men can be very insensitive." C. "I understand completely. My husband divorced me, too." D. "You are depressed now, but you will feel better in time."

A

Erik is a staff nurse on a surgical unit. He has been selected as leader of a newly established group of staff nurses organized to determine ways to decrease the number of medication errors occurring on the unit. Erik has definite ideas about how to bring this about. He has also applied for the position of Head Nurse on the unit and believes that if he is successful in leading the group toward achievement of its goals, he can also facilitate his chances for promotion. At each meeting, he addresses the group in an effort to convince the members to adopt his ideas. Which type of group and style of leadership is described in this situation? A. Task group, autocratic leadership. B. Teaching group, autocratic leadership. C. Self-help group, democratic leadership. D. Supportive-therapeutic group, laissez-faire leadership.

A

How do anti-anxiety medications, such as benzodiazepines, produce a calming effect? A. Depression the CNS. B. Decreasing levels of norepinephrine and serotonin in the brain. C. Decreasing levels of dopamine in the brain. D. Inhibiting production of the enzyme MAO.

A

Jack is a new client on the psychiatric unit with a diagnosis of antisocial personality disorder. Which of the following characteristics would you expect to assess in Jack? A. Lack of guilt for wrongdoing. B. Insight into his own behavior. C. Ability to learn from past experiences. D. Compliances with authority.

A

Joe, an American Indian, appears at the community health clinic with an oozing stasis ulcer on his lower right leg. It is obviously infected, and he tells the nurse that the shaman has been treating it with herbs. The nurse determines that Joe needs emergency care, but Joe states he will not go to the emergency department (ED) unless the shaman is allowed to help treat him. How should the nurse handle this situation? A. Contact the shaman and have him meet them at the ED to consult with the attending physician. B. Tell Joe that the shaman is not allowed in the ED. C. Explain to Joe that the shaman is at fault for his leg being in the condition it is in now. D. Have the shaman try to talk Joe into going to the ED without him.

A

John, a veteran of the war in Iraq, is diagnosed with PTSD. Which of the following therapy regimens would most appropriately be ordered for John. A. Paroxetine and group therapy. B. Diazepam and implosion therapy. C. Alprazolam and behavior therapy. D. Carbamazepine and cognitive therapy.

A

Kim, a client diagnosed with borderline personality disorder, manipulates the staff in an effort to fulfill her own desires. All of the following may be examples of behaviors in the borderline client except: A. Refusal to stay in from alone, stating "it's so lonely." B. asking nurse Jones for cigarettes after 30 minutes, knowing the assigned nurse has explained she must wait an hour. C. Stating to nurse Jones, "I really like having you for my nurse. You're the best one around here." D. Cutting arms with razor blade after discussing dismissal plans with physician.

A

Lorraine has been diagnosed with somatic symptom disorder. Which of the following symptom profiles would you expect when assessing Lorraine? A. Multiple somatic symptoms in several body systems. B. Fear of having a serious disease. C. Loss or alteration in sensorimotor functioning. D.Belief that her body is deformed or defective in some way.

A

Mark, who has come to the mental health clinic with symptoms of depression, says to the nurse, "My father is dying. I have always hated my father. He physically abused me when I was a child. We haven't spoken for many years. He wants to see me now, but I don't know if I want to see him." With which spiritual need is Joe struggling? A. Forgiveness B. Faith C. Hope D. Meaning and purpose in life

A

Mr. White is admitted to the hospital after an extended period of binge alcohol drinking. His wife reports that he has been a heavy drinker for a number of years. Laboratory reports reveal he has a blood alcohol level of 250 mg/dL. He is placed on the chemical addiction unit for detoxification. When would the first signs of alcohol withdrawal symptoms be expected to occur? A. Several hours after the last drink. B. 2 to 3 days after the last drink. C. 4 to 5 days after the last drink. D. 6 to 7 days after the last drink.

A

Mr. and Mrs. Smith and their three children (ages 5, 8, and 10) are in therapy with the nurse psychotherapist. Mrs. Smith tells the nurse that their marriage has been "falling apart" since the birth of their youngest child, Tom. She explains that they "did not want a third child, and I became pregnant even after my husband had undergone a vasectomy. We were very angry, the pregnancy was a problematic one, and the child has been difficult since birth. We had problems before he was born, but since Tom was born, things have gone from bad to worse. No one can control him, and he is wrecking our family!" The nurse assess that which of the following may be occurring in this family? A. Scapegoating. B. Triangling. C. Disengagement. D. Enmeshment.

A

Mrs. S asks the nurse, "Do you think I should tell my husband about my affair with my boss?" Which is the most appropriate response by the nurse? A. "What do you think would be best for you to do?" B. "Of course you should. Marriage has to be based on truth." C. "Of course not. That would only make things worse." D. "I can't tell you what to do. You have to decide for yourself?"

A

One of the goals of therapeutic community is for clients to become more independent and accept self-responsibility. Which of the following approaches by staff best encourages fulfillment of this goal? A. Including client input and decisions into the treatment plan. B. Insisting that each client take a turn as "president" of the community meeting. C. Making decisions for the client regarding plans for treatment. D. Requiring that the client be bathed, dressed, and attend breakfast on time each morning.

A

Part of the nurse's continual assessment of the client taking antipsychotic medications is to observe for extrapyramidal symptoms. Which of the following are examples of extrapyramidal symptoms? A. Muscular weakness, rigidity, tremors, facial spasms. B. Dry mouth, blurred vision, urinary retention, orthostatic hypotension. C. Amenorrhea, gynecomastia, retrograde ejaculation. D. Elevated blood pressure, severe occipital headache, stiff neck.

A

Sam has a diagnosis of major depression. After an unsuccessful trail of antidepressant medication, Sam's physician has hospitalized him for a course of ECT treatments. Sam says to the nurse on admission, "I don't want to end up like McMurphy in One Flew Over the Cuckoo's Nest! I'm scared!" What is Sam's priority nursing diagnosis at this time? A. Anxiety related to deficient knowledge about ECT. B. Risk for injury related to risk associated with ECT. C. Deficient knowledge related to negative media presentation of ECT. D. Acute confusion related to side effects of ECT.

A

Sandra is the nurse leader of a supportive therapeutic group for individuals with anxiety disorders. Violet, who is beautiful but lacks self-confidence, states to the group, "Maybe if I became a blond my boyfriend would love me more." Larry responds, "Listen, dummy, you need more than blond hair to keep the guy around. A bit more in the brains department would help!" What type of member role is Larry assuming in this group?" A. Aggressor. B. Monopolizer. C. Blocker. D. Seducer.

A

Shane, a veteran of the war in Iraq, has been diagnosed with PTSD. He is a client of the VA outpatient clinic. He tells the nurse that he experiences panic attacks. Which of the following medications may be prescribed for Shane to treat his panic attacks? A. Alprazolam B. Lithium C. Carbamazepine D. Haldol

A

Simone, a depressed client who has been unkempt and untidy for weeks, today comes to group therapy wearing makeup and a clean dress with hair washed and combed. Which of the following responses by the nurse is most appropriate? A. "Simone, I see you have put on a clean dress and combed your hair." B. "Simone, you look wonderful today." C. "Simone, I'm sure everyone will appreciate that you have cleaned up for the group today." D. "Now that you see how important it is, I hope you will do this every day."

A

The Mauldsley approach to treatment of adolescents with anorexia nervosa advances which of the following fundamental concepts? A. Family should be actively involved in each phase of treatment. B. Parents should be prohibited from involvement in helping their child eat more, since there are often control issues. C. Adolescents need to work on developing healthy self-identities before they can begin to gain weight. D. Individual psychotherapy is the most effective treatment for adolescents with anorexia nervosa.

A

The Quality and Safety Education for Nurses guidelines identify that student nurses need to be well schooled on informatics. This most directly refers to which of the following? A. Learning how to effectively communicate information using electronic health records. B. Learning the SBAR method of reporting information. C. Learning guidelines for preventing lawsuits. D. Learning information about new treatments to keep nursing skills current.

A

The client says to the nurse, "I've been offered a promotion, but I don't know if I can handle it." The nurse replies, "You're afraid you may fail in the new position." This is an example of which therapeutic technique? A. Restating B. Making observations C. Focusing D. Verbalizing the implied

A

The most appropriate nursing intervention with Jenny (from question 5) would be to: A. Facilitate arrangements for her to start attending Alateen meetings. B. Help her identify the positive things in her life and recognize that her situation could be a lot worse than it is. C. Teach her about the effects of alcohol on the body and that it can be hereditary. D. Refer her to a psychiatrist for private therapy to learn to deal with her home situation.

A

The nurse decides to respect family wishes amd mot tell the client of his terminal status because that would bring the most happiness to the most people. Which of the following ethical theories is considered in this decision? A. Utilitarianism B. Kanianism C. Christian Ethics D. Ethical Egoism.

A

The nurse hears John, a client with a history of violence, yelling in the day room. The nurse observes his increased agitation, clenched fists, and loud, demanding voice. He is challenging and threatening staff and the other clients. The nurse's priority intervention would be to: A. Call for assistance. B. Draw up a syringe of pen haloperidol. C. Ask John if he would like to talk about his anger. D. Tell John if he does not calm down he will have to be restrained.

A

The nurse identifies the primary nursing diagnosis for Theresa as Risk for suicide related to the feelings of hopelessness from loss of relationship. Which is the outcome criterion that would be most appropriate for this diagnosis? A. The client has experienced no physical harm to herself. B. The client sets realistic goals for herself. C. The client expresses some optimism and hope for the future. D. The client has reached a stage of acceptance in the loss of relationship with her boyfriend.

A

The nurse is using nursing process to care for a client who is suicidal. Which of the following nursing actions is a part of the diagnosis step of the nursing process? A. Identifies nursing diagnosis: Risk for suicide. B. Notes that client's family reports recent suicide attempt. C. Prioritizes the necessity of maintaining a safe client environment. D. Obtains a short-term contract from the client to seek out staff if feeling suicidal.

A

The nurse is using nursing process to care for a client who is suicidal. Which of the following nursing actions is a part of the planning step of the nursing process? A. Prioritizes the necessity for maintaining a safe environment for the client. B. Determines if nursing interventions have been appropriate to achieve desired results. C. Obtains a short-term contract from the client to seek out staff if feeling suicidal. D. Establishes goal of care: Client will not harm self during hospitalization.

A

The physician orders lithium carbonate 600mg tid for a newly diagnosed client with bipolar I disorder. There is a narrow margin between the therapeutic and toxic levels of lithium. The therapeutic range for acute mania is: A. 1.0 to 1.5 mEq/L B. 10 to 15 mEq/L C. 0.5 to 1.0 mEq/L D. 5 to 10 mEq/L

A

The physician orders sertraline (Zoloft) for a client who is hospitalized with adjustment disorder with depressed mood. This medication is intended to: A. Increase energy and elevate mood. B. Stimulate the central nervous system. C. Prevent psychotic symptoms. D. Produce a calming effect.

A

The thought recording (two-column and three-column) cognitive therapy techniques help clients: A. Identify automatic thoughts. B. Modify automatic thoughts. C. Identify rational alternatives. D. All of the above.

A

Tommy says to his friend, "I can't even talk to my Daddy until after he has read his newspaper." This is an example of which of the following? A. A rigid boundary. B. A boundary violation. C. An enmeshed boundary. D. A flexible boundary.

A

Using the structural approach with a family in therapy, the therapist would: A. Try to change family principles that may be promoting dysfunctional behavior patterns. B. Strive to create change in destructive behavior through improvement in communication and interaction patterns. C. Encourage increase in the differentiation of individual family members. D. Promote change in dysfunctional behavior by encouraging the formation of more diffuse boundaries between family members.

A

What is the ultimate goal of therapy for a client with dissociative identity disorder> A. Integration of the personalities into one. B. The ability to switch from one personality to another voluntarily. C. The ability to select one personality as the dominant self. D. Recognition that the various personalities exist.

A

When Frank's wife of 34 years dies, he is very stoic, handles all the funeral arrangements, does not cry or appear sad, and comforts all of the other family members in their grief. Two years later, when Frank's best friend dies, Frank has sleep disturbances, difficulty concentrating, loss of weight, and difficulty preforming his job. This is an example of which of the following maladaptive responses to loss? A. Delayed grieving B. Distorted grieving C. Prolonged grieving D. Exaggerated grieving

A

When Jack is not accepted at the law school of his choice he thinks, "I'm so stupid. No law school will ever accept me." What automatic thought does this statement represent? A. Overgeneralization B. Magnification C. Selective Abstraction D. Minimization

A

When an individual's stress response is sustained over a long period, the endocrine system involvement results in which of the following? A. Decreased resistance to disease. B. Increased libido. C. Decreased blood pressure. D. Increased inflammatory response.

A

Which medication has been used with some success in clients with anorexia nervosa? A. Lorcaserin (Belviq) B. Diazepam (Valium) C. Fluoxetine (Prozac) D. Carbamazepine (Tegretol)

A

Which of the following behavioral patterns is characteristic of individuals with narcissistic personality disorder? A. Overly self-centered and exploitative of others. B. Suspicious and mistrustful of others. C. Rule conscious and disapproving of change. D. Anxious and socially isolated.

A

Which of the following factors is NOT associated with increased incidence of NCD due to Alzheimer's disease? A. Multiple small strokes. B. Family history of Alzheimer's disease. C. Head trauma. D. Advanced age.

A

Which of the following hormones has been implicated in the etiology of mood disorder with seasonal pattern? A. Increased levels of melatonin B. Decreased levels of oxytocin C. Decreased levels of prolactin D. Increased levels of thyrotropin

A

Which of the following individuals is at highest risk for a suicide attempt? A. John, who reports he is in deep emotional pain, feels hopeless, and says "No one is there for me." B. Kelly, who has been seeing a doctor for chronic, intractable pain and is taking pain medication. C. Jim, an American Indian who just graduated from high school with honors. D. Mike, a physician who reports feeling "burnt out" and is considering retirement.

A

Which of the following is a correct statement when attempting to distinguish normal grief from clinical depression? A. In clinical depression, anhedonia is present. B. In normal grieving, the person has generalized feelings of guilt. C. The person who is clinically depressed related feelings of depression to a specific loss. D. In normal grieving, there is a persistent state for dysphoria.

A

Which of the following is least likely to predispose a child to Tourette's disorder? A. Absence of parental bonding. B. Family history of disorder. C. Abnormallities of brain neurotransmitters. D. Structural abnormalities of the brain.

A

Which of the following is thought to facilitate the grief process? A. The ability to grieve in anticipation of the loss. B. The ability to grieve alone without interference from others. C. Having recently grieved for another loss. D. Taking personal responsibility for the loss.

A

Which of the following medications may be prescribed for early ejaculation? A. Paroxetine B. Tadalafil C. Diazepam D. imipramine

A

Which of the following nursing diagnoses would be considered the priority in planning care for the child with severe autism spectrum disorder? A. Risk for self-mutilation evidenced by banging head against wall. B. Impaired social interaction evidenced by unresponsiveness to people. C. Impaired verbal communication evidenced by absence of verbal expression. D. Disturbed personal identity evidenced by inability to differentiate self from others.

A

Which of the following outcome criteria would be most appropriate for the client described in question 1? A. Kaylee is able to express positive aspects about herself and her life situation. B. Kaylee is able to accept constructive criticism without becoming defensive. C. Kaylee is able to develop positive interpersonal relationships. D. Kaylee is able to accept positive feedback from others.

A

Which of the following parts of the brain is associated with voluntary body movement, thinking and judgement, and expression of feeling? A. Frontal Lobe B. Parietal Lobe C. Temporal Lobe D. Occipital Lobe

A

Which of the following parts of the brain is concerned with hearing, short-term memory, and sense of smell? A. Temporal Lobe B. Parietal Lobe C. Cerebellum D. Hypothalamus

A

You and your best friend, Jill, have had plans for 6 months to go on vacation together to Hawaii. You have saved your money and have plane tickets to leave in 3 weeks. She has just called you and reported that she is not going. She has a new boyfriend, they are moving in together, and she does not want to leave him. You are very angry with Jill for changing your plans. Which of the following is an example of an assertive response? A. "I'm very disappointed and very angry. I'd like to talk to you about this later. I'll call you." B. "I'm very happy for you, Jill. I think it's wonderful that you and Jack are moving in together." C. You tell Jill that you are very happy for her, nut then say to another friend, "Well, that's the end of my friendship with Jill!" D. "What? You can't do that to me! We've had plans! You're acting like a real slut!"

A

You are having company for dinner, and they are due to arrive in 20 minutes. You are about to finish cooking and still have to shower and dress. The doorbell rings and it is a man selling a new product for cleaning windows. Which of the following is an example of an aggressive response? A. "I don't do windows!" and slam the door in his face. B. "I'll take a case," and write him a check. C. "Sure, I'll take three bottles." then to yourself you think: "I'm calling this company tomorrow and complaining to the manager about their salespeople coming around at dinnertime!" D. "I'm very busy at the moment. I don't wish to purchase any of your product. Thank you."

A

You have been studying for a nursing exam all afternoon and lost track of time. Your husband expects dinner on the table when he gets home from work. You have not started cooking yet when he walks in the door and shouts, "Why the heck isn't dinner ready?" Which of the following is an example of a passive-aggressive response? A. "I'm sorry. I'll have it done in no time, honey." But then you move very slowly and take a long time to cook the meal. B. "I'm tired from studying all afternoon. Make your own dinner, you bum! I'm tired of being your slave!" C. "I haven't started dinner yet. I'd like some help from you." D. "I'm so sorry. I know you're tired and hungry. It's all my fault. I'm such a terrible wife!"

A

You're on your way to the laundry room when you encounter a fellow dorm tenant who often asks you to "throw a few of my things in with yours." You view this as an imposition. He asks you where you're going. Which of the following is an example of a passive-aggressive response? A. "I'm on my way to the Celtics game. Where do you think I'm going?" B. "I'm on my way to do some laundry. Do you have anything you want me to wash with mine?" C. "It's none of your damn business!" D. "I'm going to the laundry room. Please don't ask me to do some of yours. I resent being taken advantage of in that way."

A

Guidelines relating on "duty to warn" state that a therapist should consider taking action to warn a third party when his or her client does which of the following? (SATA) A. Threatens violence toward another individual. B. Identifies a specific intended victim. C. Is having command hallucinations. D. Reveals paranoid delusions about another individual.

A, B

Annie has trichotillomania. She is receiving treatment at the mental health clinic with habit-reversal therapy. Which of the following elements would be included in this therapy. (SATA) A. Awareness training. B. Competing response training. C. Hypnotherapy D. Aversive therapy

A, B, C

John comes to the mental health clinic with reports of anxiety and depression. According to the transactional model of stress and adaptation, which of the following are important to consider when assessing John's complaints? (SATA) A. John's perception of precipitating events. B. Past stressors and degree of positive coping abilities. C. Existing social supports. D. Physical strength. E. Pupillary adaptation to light.

A, B, C

Lashona was sexually abused as a child. She is a client on the milieu unit with a diagnosis of Borderline Personality Disorder. She has refused to talk to anyone. Which of the following therapies might the IDT team choose for Lashona? (Select all that apply) A. Music therapy B. Art therapy C. Psychodrama D. Electroconvulsive therapy

A, B, C

Psychotropic medications may act at the neural synapse to accomplish which of the following? (SATA) A. Inhibit the reuptake of certain neurotransmitters, creating more availability. B. Inhibit catabolic enzymes, promoting more availability of a neurotransmitter. C. Block receptors, resulting in the less neurotransmitter activity. D. Add synthetic neurotransmitters found in the drug.

A, B, C

Which of the following are basic assumptions of milieu therapy? (Select all that apply) A. The client owns his or her own environment. B. Each client owns his or her behavior. C. Peer pressure is a useful and powerful tool. D. Inappropriate behaviors are punished immediately.

A, B, C

Which of the following behaviors suggest a possible breach of professional boundaries? (Select all that apply) A. The nurse repeatedly request to be assigned to a specific client. B. The nurse shares the details of her divorce with the client. C. The nurse makes arrangements to meet the client outside of the therapeutic environment. D. The nurse shares how she dealt with a similar difficult situation.

A, B, C

Which of the following interventions are appropriate for a client on suicide precautions? (SATA) A. Remove all sharp objects, belts, and other potentially dangerous articles from the client's environment. B. Accompany the client to off-unit activities. C. Reassess intensity of suicidal thoughts and urges on a regular basis. D. Put all of the client's possessions in storage and explain to her she may have them back when she is off suicidal precautions.

A, B, C

Which of the following is true about aggression? (SATA) A. It is goal-directed. B. Its aim is to do harm to a person or object. C. It has a requisite of intent. D. It energizes and mobilizes the body for self-defense.

A, B, C

Which of these procedures is important immediately following an episode of violence on the unit? (SATA) A. Document all observations and occurrences. B. Conduct a debriefing with staff. C. Discuss what occurred with other clients who witnessed the incident. D. Warn the client that it could happen again if he becomes violent.

A, B, C

Amy's husband of 1 year left 2 weeks ago for a year-long deployment in Afghanistan. Amy makes an appointment with the psychiatric nurse practitioner at the community mental health clinic. She tells the nurse that she can't sleep, has no appetite, is chronically fatigued, and thinks about her husband constantly and fears for his life. Which of the following might the nurse suggest/prescribe for Amy? (SATA) A. A prescription for sertraline, 50 mg/day. B. Participation in a support group. C. Resuming involvement in usual activities. D. Regular relaxation exercises.

A, B, C, D

Anna has been a widow for 20 years. Her maladaptive grief response to the loss of her dog may be attributed to which of the following? (SATA) A. Unresolved grief over the loss of her husband. B. Loss of several relatives and friends over the last few years. C. Repressed feelings of guilt over the way Lucky died. D. Inability to prepare in advance for the loss

A, B, C, D

Mandy presents in the emergency department with complaints of suicidal ideation. The following data is collected by the nurse. Which of these assessment findings suggests that bulimia nervosa might be a health problem? (SATA) A. Mandy's parotid glands appear enlarged. B. Mandy's teeth have a "moth eaten" pattern of tooth decay. C. Mandy reports that she takes laxatives daily. D. Mandy's weight is within the expected range.

A, B, C, D

S.T. is a 15-year-old girl who has just been admitted to the adolescent psychiatric unit with a diagnosis of anorexia nervosa. She is 5 feet 5 inches tall and weighs 82 lb. She was elected to the cheerleading squad for the fall but states that she is not as good as the others on the squad. The treatment team has identified the following problems: refusal to eat, occasional purging, refusing to interact with staff and peers, and fear of failure. Which of the following nursing diagnoses would be appropriate for S.T.? (Select all that apply) A. Social Isolation. B. Disturbed Body Image. C. Low Self-Esteem. D. Imbalanced Nutrition: Less than body requirements.

A, B, C, D

Which of the following conditions increases the risk of adverse events associated with ECT? (SATA) A. Increased intracranial pressure. B. Recent myocardial infarction. C. Severe underlying hypertension. D. Congestive heart failure. E. Breast cancer.

A, B, C, D

Which of the following is most likely to initiate a grief response in an individual? (SATA) A. Death of a pet dog. B. Being told by her doctor that she has begun menopause. C. Failing an exam. D. Losing a spouse through divorce.

A, B, C, D

A client admitted to the emergency department smells strongly of alcohol, and his wife reports he has been a heavy drinker for the last 25 years. Which of the following assessment findings are consistent with long-term chronic alcohol abuse? (SATA) A. The client reports weak leg muscles, and his gait is unsteady. B. The client's abdomen is distended. C. The client reports he was coughing up some blood. D. The client reports he has double vision. E. Blood tests reveal a low white blood cell count.

A, B, C, D, E

A client comes to the mental health clinic with a complaint of lack of sexual desire. In the initial interview, what assessments would the nurse make. (SATA) A. Mood B. Energy level C. Medications being taken D. Previous level of sexual activity

A, B, C. D

An individual may be considered gravely disabled for which of the following reasons? (SATA) A. A person, because of mental illness, cannot fulfill basic needs. B. A mentally ill person is in danger of physical harm based on inability to care for himself or herself. C. A mentally ill person lacks the resources to provide the necessities of life. D. A mentally ill person is unable to make use of available resources to meet daily living requirements.

A, B, D

Dana's husband, who was deployed in Afghanistan a year ago, is returning home this week. Which of the following postdeployment situations may be likely to occur during the first few months of his return? (SATA) A. A honeymoon period of physical reconnection. B. Resistance from the spouse regarding possible loss of autonomy. C. Rejection by the children for perceived abandonment. D. A period of adjustment to reconnect emotionally.

A, B, D

John, a client with a history of violence, has been hospitalized on the psychiatric unit. He becomes agitated and begins to threaten the staff and other clients. When all other interventions fail, John is placed in restraints in the seclusion room for his and others' protection. Which of the following are interventions for the client in restraints? (SATA) A. Check temperature and pulse of extremities. B. Document all observations. C. Explain to the client that restraint is his punishment for violent behavior. D. Provide ongoing assessment and observation. E. Withhold food and fluid until client is calm and can be released from restraints.

A, B, D

The environment in which the communication takes place influences the outcome of the interaction. Which of the following are aspects of the environment that influence communication? (Select all that apply) A. Territoriality B. Density C. Dimension D. Distance E. Intensity

A, B, D

A client wither ectile disorder has a new prescription for sildenafil. The nurse who is providing education about this medication tells the client that which of the following are common side effects of this medication? (SATA) A. Headache B. Facial flushing C. Constipation D. Nasal congestion E. Indigestion

A, B, D, E

A nurse is engaging in psychoeducation about improving self-esteem with Shelley, who has depression and low self-esteem. Which of the following are important for the nurse to assess? (Select all that apply) A. Shelley's focal, contextual, and residual stimuli. B. Shelley's abilities with regard to establishment of boundaries. C. Shelley's age and whether or not she is married. D. The nurse's awareness of his or her own ability to establish appropriate boundaries. E. Shelley's predominant communication style and her understanding of assertiveness.

A, B, D, E

On the milieu unit, duties of the staff psychiatric nurse include which of the following? (Select all that apply) A. Medication administration B. Client teaching C. Medical diagnosis D. Reality orientation E. Relationship development F. Group therapy

A, B, D, E

Recent research on the RAISE approach to treatment of schizophrenia incorporates which of the following elements as important to improving outcomes. (SATA) A. Early intervention at the first episode of psychosis. B. Support for employment and/or educational psychosis. C. Rapid high-dose loading with antipsychotic medication. D. Court-ordered sanctions for treatment. E. Recovery-focused psychotherapy.

A, B, E

Which of the following medications have been indicated for improvement in cognitive functioning in mild to moderate Alzheimers disease? (SATA) A. Donepezil (Aricept) B. Rivastigmine (Exelon) C. Sertraline (Zoloft) D. Galantamine (Razadyne)

A, B, E

Trauma-informed care is a philosophical approach that includes which of the following principles? (SATA) A. Nurses need to be aware of the potential for trauma in any client and provide care that minimizes the risk of revictimization or retraumatization. B. Medications need to be given before any other interventions are considered. C. Trauma-informed care highlights the importance of providing care that protects the physical, psychological, and emotional safety of the client. D. Trauma-informed care is based on the principle that traumas are not correlated with depression of increased risk for suicide.

A, C

Although historically lithium has been the medication of choice for mania, several others have been used with good results. Which of the following are used in the treatment of bipolar disorder? (SATA) A. Olanzapine (zyprexa) B. Oxycodone (OxyContin) C. Carbamazepine (Tegretol) D. Gabapentin (Neurontin) E. Tranylcypromine (Parnate)

A, C, D

Mike a veteran of combat in Afghanistan, has a diagnosis of mild TBI. The psychiatric home health nurse from the VA medical center is assigned to make home visits to Mike and his wife, Marissa, who is his caregiver. Which of the following would be an appropriate nursing intervention by the home health nurse? (SATA) A. Assess for use of substances by Mike or Marissa. B. Encourage Marissa to do everything for Mike to prevent further deterioration of his condition. C. Assess Marissa's level of stress and potential burnout. D. Encourage Marissa to allow Mike to be as independent as possible. E. Suggest that Marissa ask the physician for a nursing home placement for Mike.

A, C, D

Which of the following behaviors are associated with the phenomenon of transference? (Select all that apply) A. The client attributes toward the nurse feelings associated with a person from the client's past. B. The nurse attributes toward the client feelings associated with a person from the nurse's past. C. The client forms an overwhelming affection for the nurse. D. The client becomes excessively dependent on the nurse and forms unrealistic expectations of him or her.

A, C, D

Which of the following describe advantages of electronic health records (EHRs)? (Select all that apply) A. They reduce redundancy of information. B. They reduce privacy issues. C. They decrease charting time. D. They facilitate communication between disciplines.

A, C, D

The nurse is in the emergency department encounters a patient, Niko, who is expressing suicide ideation. The nurse recognizes that which of the following considerations are important to good suicide risk assessment? (SATA) A. Collaborating with the patient. B. Asking specific questions about leisure activities. C. Establishing trust and open communication with the patient. D. Asking the patient-specific questions about the strength of his intention to die. E. Identifying whether the patient has thought about a plan for trying to kill himself.

A, C, D, E

In addition to disturbances in cognition and orientation, individuals with Alzheimer's disease may also show changes in which of the following? (SATA) A. Personality B. Vision C. Speech D. Hearing E. Mobility

A, C, E

The nurse is prioritizing nursing diagnoses in the plan of care for a client experiencing a manic episode. Number the diagnoses in order of the appropriate priority. A. Disturbed sleep pattern evidenced by sleeping only 4 to 5 hours per night. B. Risk for injury related to manic hyperactivity. C. Impaired social interaction evidenced by manipulation of others. D. Imbalanced nutrition: Less than body requirements evidenced by loss of weight and poor skin turgor.

A-3 B-1 C-4 D-2

"Splitting" by the client with BPD denotes: A. Evidence of precocious development. B. A primitive defense mechanism in which the client sees objects as all good or all bad. C. A brief psychotic episode in which the client loses contact with reality. D. Two distinct personalities within the borderline client.

B

A client states: "I refuse to shower in this room. I must be very cautious. The FBI placed a camera in here to monitor my every move." Which of the following is the therapeutic response? A. "That's not true." B. "I have a hard time believing that's true." C. "Surely you don't believe that." D. "I will help you search this room so that you can see there is no camera."

B

A client tells the therapist, "I thought I would just die when my husband told me he was leaving me. If I had been a better wife, he wouldn't have fallen in love with another woman. It's all my fault." The therapist wants to use the technique of "examining the evidence." Which of the following statements reflects this technique? A. "How do you think you could have been a better wife?" B. "Okay, you say it's all your fault. Let's discuss why it might be your fault, and then we will look at who it may not be." C. "Let's talk about what would make you a happier person." D. "Would you have wanted him to stay if he didn't really want to?"

B

A decrease in which of the following neurotransmitters has been implicated in depression? A. Gamma-aminobutyric acid, acetylcholine, and dopamine. B. Norepinephrine, serotonin, and dopamine. C. Somatostatin, substance P, and glycine. D. Glutamate, histamine, and opioid peptides.

B

A fellow worker often borrows small amounts of money from you with the promise that she will pay you back "tomorrow." She currently owes you $15, and has not yet paid back any that she has borrowed. She asks if she can borrow a couple of dollars for lunch. Which of the following is an example of a nonassertive response? A. "I've decided not to loan you any more money until you pay me back what you already borrowed." B. "I'm so sorry. I only have enough to pay for my own lunch today." C. "Get a life, will you? I'm tired of you sponging off me all the time!" D. "Sure, here's two dollars." Then to the other workers in the office: "Be sure you never lend Cindy any money. She never pays her debts. I'd be sure never to go to lunch with her if I were you!"

B

A major difference between normal and maladaptive grieving has been identified by which of the following? A. There are no feelings of depression in normal grieving. B. There is no loss of self-esteem in normal grieving. C. Normal grieving lasts no longer than 1 year. D. In normal grief there person does not show Anger toward the loss.

B

A nurse is educating a client about his lithium therapy and explaining signs and symptoms of lithium toxicity. Which of the following would she instruct the client to be on alert for? A. Fever, sore throat, malaise B. Tinnitus, severe diarrhea, ataxia C. Occipital headache, palpitations, chest pain D. Skin rash, marked rise in blood pressure, bradycardia

B

A patient has been ordered ECT and asks the nurse, "Exactly how does ECT work?" Which of the following is the most accurate response by the nurse? A. "I'm not allowed to tell you that because that would be informed consent." B. "The exact mechanism is unknown, but there are several ways that ECT may have antidepressant effects." C. "the administration of a shock to the brain induces memory loss, Which will make you forget that you are depressed." D. "The neuroplasticity affected by seizure activity prevents further brain damage."

B

Abby, an adolescent, just returned from group therapy and is crying. She says to the nurse, "All the other kids laughed at me! I try to fit in, but I always seem to say the wrong thing. I've never had a close friend. I guess I never will." Which is the most appropriate response by the nurse? A. "What makes you think you will never have any friends." B. "You're feeling pretty down on yourself right now." C. "I'm sure they didn't mean to hurt your feelings." D. "Why do you feel this way about yourself?"

B

An aversive stimulus or punisher: A. Increases the probability that a behavior will recur. B. Decreases the probability that a behavior will recur. C. Has nothing to do with the modifying behavior. D. Always results in unacceptable behavior.

B

Anna has been grieving the death of Lucky for 3 years. She is unable to take care of her normal activities because she insists on visiting Lucky's grave daily. What is the most likely reason that Anna's daughter has put off seeking help for Anna? A. Women are less likely than men to seek help for emotional problems. B. Relatives often try to normalize behavior rather than label it a mental illness. C. She knows that all older people are expected to be a little depressed. D. She is afraid that the neighbors will think her mother is "crazy".

B

Anne, age 24, and her husband are seeking treatment at the sex therapy clinic. They have been married for 3 weeks and have never had sexual intercourse together. Pain and vaginal tightness prevent penile entry. Sexual history reveals Anne was raped when she was 15 years old. The physician would most likely assign which of the following diagnoses to Anne? A. Female orgasmic disorder B. Genito-pelvic pain/ penetration disorder. C. Female sexual interest / arousal disorder. D. Sexual aversion disorder.

B

Antipsychotic medications are thought to decrease psychotic symptoms by: A. Blocking reuptake of norepinephrine and serotonin. B. Blocking the action of dopamine in the brain. C. Inhibiting production of the enzyme MAO. D. Depressing CNS.

B

Atropine sulfate is administered to a client receiving ECT for what purpose? A. To alleviate anxiety. B. To decrease secretions. C. To relax muscles. D. As a short-acting anesthetic.

B

B.J. has been out with his friends. He is late getting home. He knows his wife will be angry and will yell at him for being late. He stops at the florist and buys a dozen red roses for her. Which of the following behaviors represents an aversive stimulus on the part of the wife? A. She meets him at the door, accepts the roses, and says nothing further about his being late. B. She meets him at the door, yelling that he is late, and makes him spend the night on the couch. C. She meets him at the door, expresses delight with the roses, and kisses him on the cheek. D. she meets him at the door and says, "How could you? You know I am allergic to roses!"

B

Barbra burned the toast. She thinks, "I'm a totally incompetent person." What automatic thought does this statement represent? A. Selective Abstraction B. Magnification C. Minimization D. Personalization

B

Carla watches her neighbor through his window each night as he undresses for bed. Later, she fantasizes about having sex with him. This is an example of which paraphilic disorder? A. Exhibitionistic disorder B. Voyeuristic disorder C. Frotteuristic disorder D. Pedophilic disorder.

B

Dan, who has been admitted to the alcohol rehabilitation unit after being fired for drinking on the job, states to the nurse, "I don't have a problem with alcohol. I can handle my booze better than anyone I know. My boss is a jerk! I haven't missed any more days than my coworkers." What is the nurse's best response? A. "Maybe your boss is mistaken, Dan." B. "You are here because your drinking was interfering with your work, Dan." C. "Get real, Dan! You're a boozer and you know it!" D. "Why do you think your boss is a jerk, Dan."

B

Doses of bupropion should be administered at least 4 to 6 hours apart and never doubled when a dose is missed in order to prevent: A. Orthostatic Hypotension B. Seizures C. Hypertensive Crisis D. Extrapyramidal Symptoms

B

Emma, age 14, has just been admitted to the psychiatric unit for anorexia nervosa. She is emaciated and refusing to eat. What is the primary nursing diagnosis for Emma? A. Complicated grieving. B. Imbalanced nutrition: Less than body requirements. C. Interrupted family processes D. Anxiety (severe)

B

From which of the following symptoms might the nurse identify in a chronic cocaine user? A. Clear, constricted pupils. B. Red, Irritated nostrils. C. Muscle aches. D. Conjunctival redness.

B

If the foregoing extrapyramidal symptoms should occur, which of the following would be a priority nursing intervention? A. Notify physician immediately. B. Administer prn trihexyphenidyl (Artane) C. Withhold the next dose of antipsychotic medication. D. Explain to the client that these symptoms are only temporary and will disappear shortly.

B

In an effort to help the child with mild to moderate intellectual developmental disorder develop satisfying relationships with others, which of the following nursing interventions is most appropriate? A. Interpret the child's behavior for others. B. Set limits on behavior that is socially inappropriate. C. Allow the child to behave spontaneously, for he or she has no concept of right or wrong. D. This child is not capable of forming social relationships.

B

In determining the degree of suicidal risk with a client, the nurse assesses the following behavioral manifestations: Severely depressed, withdrawn, statements of worthlessness, difficulty accomplishing activities of daily living, no close support systems. The nurse identifies the client's risk for suicide as which of the following? A. Low risk B. High risk C. Imminent Risk D. Unable to be determined.

B

In establishing trust with Ellen, a client with the diagnosis of dissociative identity disorder, the nurse must: A. try to relate to Ellen as though she did not have multiple personalities. B. Listen nonjudgementally and respond empathetically when Ellen transitions to different personality states. C. Ignore behaviors that Ellen attributes to other sub-personalities. D. Explain to Ellen that he or she will work with her only if the primary personality is maintained.

B

In the community meeting, which of the following actions is most important for reinforcing the democratic posture of the therapy setting? A. Allowing each person a specific and equal amount of time to talk. B. Reviewing group rules and behavioral limits that apply to all clients. C. Reading the minutes from yesterday's meeting. D. Waiting until all clients are present before initiating the meeting.

B

Jareth has a diagnosis of generalized anxiety disorder. His physician has prescribed bus-irons 15mg daily. Jareth says to the nurse, "Why do I have to take this every day? My friend's doctor ordered Xanax for him and he only takes it when he is feeling anxious." Which of the following would be an appropriate response by the nurse? A. "Xanax is not effective for generalized anxiety disorder." B. "Buspirone must be taken daily in order to be effective." C. "I will ask the doctor if he will change your dose of buspirone to prn so that you don't have to take it every day." D. "Your friend really should be taking the Xanax every day."

B

Jessica told Andrea a secret that Eva had told her. This is an example of which of the following? A. Too flexible a boundary. B. A boundary violation. C. Too rigid a boundary. D. An enmeshed boundary.

B

John and his girlfriend had an argument during her visit. Which behavior by John would indicate he is learning to adaptively problem-solve his frustrations? A. John says to the nurse, "Give me some of that medication before I end up in restraints!" B. When his girlfriend leaves, John goes to the exercise room and punches on the punching bag C. John says to the nurse, "I guess I'm going to have to dump that broad!" D. John says to his girlfriend, "You'd better leave before I do something I'm sorry for."

B

John has sought help for his concern that he is binge eating and feels like it has "gotten out of control." He asks the nurse what can be done to help him. Which of these is the most accurate response? A. Nothing can be done. B. Some medications and psychological treatments have demonstrated effectiveness in reducing binge eating behaviors. C. The primary problem is obesity. I can help you set up a calorie-restricted diet. D. Medications can help with weight loss, but there are no medications effective for reducing binge eating.

B

John tells the nurse, "I think lights out at 10 o'clock on a weekend is stupid. We should be able to watch TV until midnight!" Which of the following is the most appropriate response from the nurse on the milieu unit? A. "John, you were told the rules when you were admitted." B. "You may bring it up before the others at the community meeting, John." C. "Some people want to go to bed early, John." D. "You are not the only person on this unit, John. You must think of others besides yourself."

B

John, a veteran of the war in Iraq, is diagnosed with PTSD. He says to the nurse, "I can't figure out why God took my buddy instead of me." From this statement, the nurse assesses which of the following in John? A. Repressed Anger B. Survivors Guilt C. Intrusive Thoughts D. Spiritual Distress

B

Josh, age 21, has been diagnosed with schizophrenia. He has been socially isolated in hearing voices telling him to kill his parents. He has been admitted to the psychiatric unit from the emergency department. The initial nursing intervention for Josh is to: A. Give him an injection of Thorazine. B. Ensure a safe environment for him and others. C. Place him in restraints. D. Order him a nutritious diet.

B

Kaylee, age 26, graduated from law school with a 3.2/4.0 grade point average. She recently took the bar exam and did not pass. Because of this, she had to give up her job at a law firm. She became very depressed and sought counseling at the mental health clinic. During the intake assessment, Kaylee says to the psychiatric nurse, "I am a complete failure. I'm so dumb, I can't do anything right." What is the most appropriate nursing diagnosis for Kaylee? A. Chronic low self-esteem. B. Situational low self-esteem. C. Defensive coping. D. Risk for situational low self-esteem.

B

Lorraine, a client diagnosed with somatic symptom disorder, states, "My doctor thinks I should see a psychiatrist. I can't imagine why he would make such a suggestion." What is the most common basis for Lorraine's statement? A. She thinks her doctor wants to get rid of her as a client. B. She does not understand the correlation of symptoms and stress. C. She thinks psychiatrists are only for "crazy" people. D. She thinks her doctor has made an error in diagnosis.

B

Margaret, a 68-year-old widow experiencing a manic episode, is admitted to the psychiatric unit after being brought to the emergency department by her sister-in-law. Margaret yells, "My sister-in-law is just jealous of me! She's trying to make it look like I'm insane!" this behavior is an example of: A. A delusion of grandeur. B. A delusion of persecution. C. A delusion of reference. D. A delusion of control or influence.

B

Margaret, a 68-year-old widow, is brought to the emergency department by her sister-in-law. Margaret has a history of bipolar disorder and has been maintained on medication for many years. Her sister-in-law reports that Margaret quit taking her medication a few months ago, thinking she no longer needed it. Margaret is agitated, pacing, demanding, and speaking very loudly. Her sister-in-law reports Margaret eats very little, is losing weight, and almost never sleeps. "I'm afraid she is going to just collapse!" Margaret is admitted to the psychiatric unit. What is the priority nursing diagnosis for Margaret? A. Imbalanced nutrition: Less than body requirements not related to eating. B. Risk for injury related to hyperactivity. C. Disturbed sleep pattern related to agitation D. Ineffective coping related to denial of depression.

B

Maria is an Italian American who is in the hospital after having suffered a miscarriage at 5 months' gestation. Her room is filled with relatives who have brought a variety of foods and gifts for Maria. They are all talking, seemingly at the same time, and some, including Maria, are crying. They repeatedly touch and hug maria and each other. How should the nurse handle this situation? A. Explain to the family that Maria needs her rest and they must all leave. B. Allow the family to remain and continue their activity as described, as long as they do not disturb other clients. C. Explain that Maria will not get over her loss if they keep bringing it up and causing her to cry so much. D. Call the family priest to come and take charge of this family situation.

B

Marie, age 56, is the mother of five children. Her youngest child, who had been living at home and attending the local college, recently graduated and accepted a job in another state. Marie has never worked outside the home and has devoted her life to satisfying the needs of her husband and children. Since the departure of her last child from home, Marie has become more and more despondent. Her husband has become very concerned, and takes her to the local mental health center. What is this type of crisis called? A. Dispositional crisis. B. Crisis of anticipated life transitions. C. Psychiatric emergency. D. Crisis resulting from traumatic stress.

B

Marissa is hospitalized on the psychiatric unit. She has a history and current diagnosis of bulimia nervosa. Which of the following symptoms would be congruent with Marissa's diagnosis? A. Binging, purging, obesity, hyperkalemia B. Bingins, purging, normal weight, hypokalemia C. Binging, laxative abuse, amenorrhea, severe weight loss D. Binging, purging, severe weight loss, hyperkalemia

B

Milieu therapy is a good choice for clients with antisocial personality disorder because it: A. Provides a system of punishment and rewards for behavior modification. B. Emulates a social community in which the client may learn to live harmoniously with others. C. Provides mostly one-to-one interaction between the client and therapist. D. Provides a very structured setting in which the clients have very little input into the planning of their care.

B

Mr. Stone is a client in the hospital with a diagnosis of vascular NCD. In explaining this disorder to Mr. Stone's family, which of the following statements by the nurse is correct? A. "He will probably live longer than if his disorder was od the Alzheimer's type." B. "Vascular NCD shows stepwise progression. This is why he sometimes seems okay." C. "Vascular NCD is caused by plaques and tangles that form in the brain." D. "The cause of vascular NCD is unknown."

B

Mrs. G. has been diagnosed with NCD due to Alzheimers disease. The primary nursing intervention in working with Mrs. G. is which of the following? A. Ensuring that she receives food she likes to prevent hunger. B. Ensuring that the environment is safe to prevent injury. C. Ensuring that she meets the other patients to prevent social isolation. D. Ensuring that she takes care of her own ADLs to prevent dependance.

B

Mrs. G., who has NCD due to Alzheimer's disease, says to the nurse, "I have a date tonight. I always have a date on Christmas." Which of the following is the most appropriate response? A. "Don't be silly, It's not Christmas, Mrs. G." B. "Today is Tuesday, October 21, Mrs. G. We will have supper soon, and then your daughter will come to visit." C. "Who is your date with, Mrs. G." D. "I think you need some more medication, Mrs. G. I'll bring it to you now."

B

Nicole is the nurse leader of a childbirth preparation group. Each week she shows films and sets out reading materials. She expects the participation to utilize their time on a topic of their choice or practice skills they have observed on the films. Two couples have dropped out of the group, stating, "This is a big waste of time." Which type of group and style of leadership is described in this situation? A. Task group, democratic leadership. B. Teaching group, laissez-faire leadership. C. Self-help group, democratic leadership. D. Supportive-therapeutic group, autocratic leadership.

B

Nina recently left her husband 10 years. She was very dependent on him and is having difficulty adjusting to an independent lifestyle. She has been hospitalized with a diagnosis of adjustment disorder with depressed mood. What is the priority nursing diagnosis for Nina? A. Risk-prone health behavior related to loss of dependancy. B. Complicated grieving related to breakup of marriage. C. Ineffective communication related to problems with dependency. D. Social isolation related to depressed mood.

B

Nina who is depressed following the breakup of a very stormy marriage, says to the nurse, "I feel so bad. I thought I would feel better once I left, but I feel worse!" Which of the best response by the nurse? A. "Cheer up, Nina. You have a lot to be happy about." B. "You are grieving the loss of your marriage. It's natural for you to feel badly." C. "Try not to dwell on how you feel. If you don't think about it, you 'll feel better." D. "You did the right thing. Nina. Knowing that should make you feel better."

B

Nurse Rosetta, who is the adult child of an alcoholic, is working with John, a client who abuses alcohol. John has experienced a successful detoxification process and is beginning a rehabilitation program. He says to Rosetta, "I'm not going to go to those stupid AA meetings. They don't help anything." Rosetta, whose father died of complications from alcoholism, responds with anger: "Don't you even care what happens to your children?" Rosetta's response is an example of which of the following? A. Transference B. Countertransference C. Self-disclosure D. A breach of professional boundaries

B

Sandra is the nurse leader of a supportive-therapeutic group for individuals with anxiety disorders. In this group, Helen talks incessantly. When someone else tries to make a comment, she refuses to allow him or her to speak. What type of member role is Helen assuming in this group? A. Aggressor. B. Monopolizer. C. Blocker. D. Seducer.

B

Sarah is an African American woman who receives a visit from the psychiatric home health nurse. A referral for a mental health assessment was made by the public health nurse, who noticed that Sarah was becoming exceedingly withdrawn. When the psychiatric nurse arrives, Sarah says to her, "No one can help me. I was an evil person in my youth, and now I must pay." How might the nurse assess this statement? A. Sarah is having delusions of persecution. B. Some African Americans believe illness is God's punishment for their sins. C. Sarah is depressed and just wants to be left alone. D. African Americans do not believe in psychiatric help.

B

Shane, a veteran of the war in Iraq, has been diagnosed with PTSD. He has been hospitalized after swelling a handful of his antigenic medication. His physical condition was stabilized in the emergency department, and he has been admitted to the psychiatric unit. In developing his initial plan of care, which is the priority nursing diagnosis that the nurse selects for Shane? A. Posttrauma syndrome. B. Risk for suicide. C. Complicated grieving. D. Disturbed thought process.

B

Sondra, who lives in Maine, hears on the evening news that 25 people were killed in a tornado in South Texas. Sondra experiences no anxiety upon hearing of this stressful situation. What is the most likely reason that Sondra experiences no anxiety? A. She is selfish and does not care what happens to other people. B. She appraises the event as irrelevant to her own situation. C. She assesses that she has the skills to cope with the stressful situation. D. She uses suppression as her primary defense mechanism.

B

Success of long-term psychotherapy with Theresa (who attempted suicide following a break-up with her boyfriend) could be measured by which of the following behaviors? A. Theresa has a new boyfriend. B. Theresa has an increased sense of self-worth. C. Theresa does not take antidepressants anymore. D. Theresa told her old boyfriend how angry she was with him for breaking up with her.

B

The initial care plan for a client with OCD who washes her hands obsessively would include which of the following nursing interventions? A. Keep the client's bathroom locked so she cannot wash her hands all the time. B. Structure the client's schedule so that she has plenty of time for washing her hands. C. Place the client in isolation until she promises to stop washing her hands so much. D. Explain the clients behavior to her, since she is probably unaware that it is maladaptive.

B

The most appropriate crisis intervention with Amanda (from question 3) would be to: A. Encourage her to recognize how lucky she is to be alive. B. Discuss stages of grief and feelings associated with each. C. Identify community resources that can help Amanda. D. Suggest that she find a place to live that provides a storm shelter.

B

The most appropriate nursing intervention with Ginger (from question 7) would be to: A. Suggest she move to a college closer to home. B. Work with Ginger on unresolved dependency issues. C. Help her find someone in the college town from whom she could seek assistance rather than calling her mother regularly. D. Recommend that the college physician prescribe an anti-anxiety medication for Ginger.

B

The nurse assists the physician with electroconvulsive therapy on a client who has refused to give concent. Which which of the following legal actions might the nurse be charged because of this nursing action? A. Assault B. Battery C. False Imprisonment D. Breach of Confidentiality

B

The nurse decides to go against family wishes and tell the client of his terminal status because that is what she would want if she were the client. Which of the following ethical theories is considered in this decision? A. Kantianism B. Christian Ethics C. Natural Law Theories D. Ethical Egoism

B

The nurse is caring for a client who has been hospitalized with anorexia nervosa and is severely malnourished. The client continues to refuse to eat. What is the most appropriate response by the nurse? A. "You know that if you don't eat, you will die." B. "If you continue to refuse to take food orally, you will be fed through a nasogastric tube." C. "You might as well leave if you are not going to follow your therapy regimen." D. "You don't have to eat if you don't want to. It is your choice."

B

The nurse is interviewing a client on the psychiatric unit. The client tilts his head to the side, stops talking midsentence, and listens intently. The nurse recognizes these behaviors as a symptom of the client's illness. The most appropriate nursing intervention for this symptom is to: A. Ask the client to describe his physical symptoms. B. Ask the client to describe what he is hearing. C. Administer a dose of benztripine. D. Call the physician for additional orders.

B

The nurse is using nursing process to care for a client who is suicidal. Which of the following nursing actions is a part of the assessment step of the nursing process? A. Identifies nursing diagnosis: Risk for suicide. B. Notes that client's family reports recent suicide attempt. C. Prioritizes the necessity of maintaining a safe client environment. D. Obtains a short-term contract from the client to seek out staff if feeling suicidal.

B

The nurse is using nursing process to care for a client who is suicidal. Which of the following nursing actions is a part of the evaluation step of the nursing process? A. Prioritizes the necessity for maintaining a safe environment for the client. B. Determines if nursing interventions have been appropriate to achieve desired results. C. Obtains a short-term contract from the client to seek out staff if feeling suicidal. D. Establishes goal of care: Client will not harm self during hospitalization.

B

The nurse must give Frank, a Latino American, a physical examination. She tells him to remove his clothing and put on an examination gown. Frank refuses. How should the nurse interpret this behavior? A. Frank does not believe in taking orders from a woman. B. Frank is modest and embarrassed to remove his clothes. C. Frank does not understand why he must remove his clothes. D. Frank does not think he needs a physical examination.

B

The nurse psychotherapist is working with the Juarez family in the outpatient mental health clinic. The husband says, "We can't agree on anything! And it seems like every time we disagree on some thing, it ends up in a screaming match." Which of the following prescriptions by the nurse represents a paradoxical intervention for the Jones family? A. Mr. and Mrs. Juarez must not have a disagreement for one full day. B. Mr. and Mrs. Juarez will yell at each other on Tuesdays and Thursdays from 8 p.m. until 8:10 p.m. C. Mr. and Mrs. Juarez must refrain from yelling at each other until the next counseling session. D. Mr. and Mrs. Juarez must not discuss serious issues until they can do so without yelling at each other.

B

The nurse says to a client, "You are being readmitted to the hospital. Why did you stop taking your medication?" What communication technique does this represent? A. Disapproving B. Requesting an explanation C. Disagreeing D. Probing

B

The nurse-therapist is counseling the Smith family: Mr. and Mrs. Smith, 10-year-old Rob, and 8-year-old Lisa. When Mr. and Mrs. Smith start to argue, Rob hits Lisa and Lisa starts to cry. The Smiths then turn their attention to comforting Lisa and scolding Rob, complaining he is "out of control and we don't know what to do about his behavior." These dynamics are an example of which of the following? A. Double-bind messages. B. Triangulation. C. Pseudohostility. D. Multigenerational transmission.

B

The primary goal in working with an actively psychotic, suspicious client would be to: A. Promote interaction with others. B. Decrease his anxiety and increase trust. C. Improve his relationship with his parents. D. Encourage participation in therapy activities.

B

The ultimate goal of therapy for a client with dissociative identity disorder is most likely achieved through: A. Crisis intervention and directed association. B. Psychotherapy and hypnosis. C. Psychoanalysis and free association. D. Insight psychotherapy and dextroamphetamine.

B

There is a very narrow margin between the therapeutic and toxic levels of lithium carbonate. Symptoms of toxicity are most likely to appear if the serum levels exceed: A. 0.15 mEq/L B. 1.5 mEq/L C. 15.0 mEq/L D. 150 mEq/L

B

Tim, age 18, babysits for his 11-year-old neighbor, Jeff. Six months ago, Tim began fondling Jeff's genitals. They now engage in mutual masturbation each time they are together. This is an example of which paraphilic disorder? A. Fetishistic disorder B. Pedophilic disorder C. Exhibitionistic disorder D. Voyeuristic disorder.

B

Twins Jan and Jean still dress alike even though they are grown and married. This is an example of which of the following? A. Rigid boundary. B. Enmeshed boundary. C. A boundary violation. D. Boundary pliancy.

B

Using the strategic approach with a family in therapy, the therapist would: A. Try to change family principles that may be promoting dysfunctional behavior patterns. B. Strive to create change in destructive behavior through improvement in communication and interaction patterns. C. Encourage increase in the differentiation of individual family members. D. Promote change in dysfunctional behavior by encouraging the formation of more diffuse boundaries between family members.

B

When the nurse shows unconditional acceptance of an individual as a worthwhile and unique human being, he or she is exhibiting which of the following characteristics? A. Trust B. Respect C. Genuineness D. Empathy

B

Which of the following activities would be a responsibility of the psychiatric clinical nurse specialist on the IDT team? A. Manages the therapeutic milieu on a 24-hour basis. B. Conducts group therapies and provides consultation and education to staff nurses. C. Directs a group of clients in acting out a situation that is otherwise too painful for a client to discuss openly. D. Locates halfway house and arranges living conditions for client being discharged from the hospital.

B

Which of the following activities would be most appropriate for the child with attention-deficit/hyperactivity disorder? A. Monopoly B. Volleyball C. Pool D. Checkers.

B

Which of the following behavioral patterns is characteristic of individuals with schizotypal personality disorder? A. Belittling themselves and their abilities. B. A lifelong pattern of social withdrawal. C. Suspicious and mistrustful of others. D. Overreacting inappropriately to minor stimuli.

B

Which of the following best describes the average number of ECT treatments given and the timing of administration? A. One treatment per month for 6 to 12 months. B. One treatment every other day, three times a week for a total of 6 to 12 treatments. C. One treatment three times per week for 6 to 12 months. D. One treatment every day for a total of 10 to 20 treatments.

B

Which of the following ego defense mechanisms describes the underlying psychodynamics of somatic symptom disorder? A. Denial of depression B. Repression of anxiety C. Suppression of grief D. Displacement of anger

B

Which of the following groups is most commonly used for drug management of the child with attention-deficit/hyperactivity disorder? A. CNS depressants (diazepam/valium) B. CNS stimulants (Methylphenidate/Ritalin) C. Anticonvulsants (phenytoin/Dilantin) D. Major tranquilizers (haloperidol/Haldol)

B

Which of the following is the leading cause of TBI in active-duty military personnel in combat? A. Military vehicle accidents. B. Blasts from explosive devices. C. Falls. D. Blows to the head from falling debris.

B

Which of the following medications is the physician most likely to order for a client experiencing alcohol withdrawal syndrome? A. Haloperidol (Haldol) B. Chlordiazepoxide (Librium) C. Methadone (Dolophine) D. Phenytoin (Dilantin)

B

Which of the following medications is used to treat Tourette's disorder? A. Methylphenidate (Ritalin) B. Haloperidol (Haldol) C. Imipramine (Tofranil) D. Phenytoin (Dilantin)

B

Which of the following parts of the brain integrates all sensory input (except smell) on the way to the cortex? A. Temporal Lobe B. Thalamus C. Limbic System D. Hypothalamus

B

Which of the following statements by Anna might suggest that she is achieving resolution of her grief over Lucky's death? A. "I don't cry anymore when i think about Lucky." B. "It's true. Lucky didn't always mind me. Sometimes he ignored my commands." C. "I remember how it happened now. I should have held tighter to his leash!" D. "I won't ever have another dog. It's just too painful to lose them."

B

Why is stress management extremely important in today's society? A. Evolution has diminished the human capability for fight-or-flight responses. B. The stressors of today tend to be ongoing, resulting in a sustained response. C. We have stress disorders that did not exist in the days of our ancestors. D. One never knows when one will have to face a grizzly bear or saber-toothed tiger in today's society.

B

You are in a movie theater that prohibits smoking. The person in the seat next to you just lit a cigarette and the smoke is very irritating. Which of the following is an example of an assertive response? A. You say nothing. B. "Please put your cigarette out. Smoking is prohibited." C. You say nothing but begin to frantically fan the air in front of you and cough loudly ad convulsively. D. "Put your cigarette out, you slob! Can't you read the 'no smoking' sign?

B

John, age 27, was brought to the emergency department by two police officers. He smelled strongly of alcohol and was combative. His blood alcohol level was measured at 293 mg/dL. His girlfriend reports that he drinks excessively every day and is verbally and physically abusive. The nurses give John the nursing diagnosis of Risk for other-directed violence. What would be appropriate outcome objectives for this diagnosis? (SATA) A. The client will not verbalize anger or hit anyone. B. The client will verbalize anger rather than hit others. C. The client will not harm self or others. D. The client will be restrained if he becomes verbally or physically abusive.

B, C

Psychoneuroimmunology is a branch of science that involves which of the following? (SATA) A. The impact of psychoactive medications at the neural synapse. B. The relationships between the immune system, the nervous system, and psychological processes including mental illness. C. The correlation between psychosocial stress and the onset of illness. D. The potential role of viruses in the onset of schizophrenia. . E. The genetic factors that influence prevention of mental illness.

B, C, D

The child with attention-deficit/hyperactivity disorder has a nursing diagnosis of impaired social interaction. Which of the following nursing interventions are appropriate for this child? (SATA) A. Socially isolate the child when interactions with others are inappropriate. B. Set limits with consequences on inappropriate behaviors. C. Provide rewards for appropriate behaviors. D. Provide group situations for the child.

B, C, D

Which of the following assessment data would the nurse consider as risk factors for possible violence in a client? (SATA) A. A diagnosis of somatization disorder. B. A diagnosis of schizophrenia or bipolar disorder. C. Substance intoxication. D. Argumentative and demanding behavior. E. Past history of violence.

B, C, D, E

A nurse on the psychiatric unit is asked to lead a psychoeducational group on self-esteem for the inpatients on the unit. It is an open group, and the nurse is aware that the attendees are multicultural. Which of the following evidence-based skills are important for the nurse to possess to effectively lead this group? (Select all that apply) A. Awareness that contact alone with people of different cultures will improve their intercultural communication. B. Skills of emotional intelligence C. Training in culturally specific language interpretation and communication styles. D. Recognition that people from cultures that do not value self-esteem will need to be prohibited from attending the group. E. An attitude of willingness to identify and correct intercultural misunderstandings when they occur.

B, C, E

Which of the following is a true statement about mental health recovery? (SATA) A. Mental health recovery applies only to serve and persistent mental illnesses. B. Mental health recovery serves to provide empowerment to the consumer. C. Mental health recovery is based on the medical model. D. Mental health recovery is a collaborative process.

B, D

Which of the following statements is correct regarding the use of restraints? (SATA) A. Restraints may never be initiated without a physician's order. B. Orders for restraints must be reissued by a physician every 2 hours for children and adolescents. C. Clients in restraints must be observed and assessed every hour for issues regarding circulation, nutrition, respiration, hydration, and elimination. D. An in-person evaluation must be conducted within 1 hour of initiating restraints.

B, D

Theresa, who has been hospitalized following a suicide attempt, is placed on suicide precautions on the psychiatric unit. She admits that she is still feeling suicidal. Which of the following interventions are most appropriate in this instance? (SATA) A. Restrict access to any item that might be harmful by placing the client in a seclusion room. B. Check on Theresa every 15 minutes at irregular intervals or assign a staff person to stay with her on a one-to-one basis. C. Obtain an order from the physician to give Theresa a sedative to calm her and reduce suicidal ideas. D. Do not allow Theresa to participate in any unit activities while she is on suicide precautions. E. Ask Theresa specific questions about her thoughts, plans, and intentions related to suicide.

B, E

Which of the following tasks are associated with the orientation phase of relationship development? (Select all that apply) A. Promoting the client's insight and perception of reality. B. Creating an environment for the establishment of trust and rapport. C. Using the problem-solving model toward goal fulfillment. D. Obtaining available information about the client from various sources. E. Formulating nursing diagnoses and setting goals.

B, E

A child with bipolar disorder also has attention-deficit/hyperactivity disorder (ADHD). How would these comorbid conditions most likely be treated? A. No medication would be given for either condition. B. Medication would be given for both conditions simultaneously. C. The bipolar condition would be stabilized before ADHD medication would be given. D. The ADHD would be treated before consideration of the bipolar disorder.

C

A client experiencing and manic episode enters the milieu area dressed in a provocative and physically revealing outfit. Which of the following is the most appropriate intervention by the nurse? A. Tell the client she cannot wear this outfit while she is in the hospital. B. Do nothing, and allow her to learn from the responses of her peers. C. Quietly walk with her back to her room and help her change into something more appropriate. D. Explain to her that if she wears this outfit, she must remain in her room.

C

A client recently admitted to the hospital reports the nurse, "I don't understand why I was brought here. I was simply hanging out in my apartment and the police said I had to come with them." this is an example of what symptom of schizophrenia? A. Delusions of reference. B. Loose association. C. Anosognosia D. Auditory hallucinations

C

A client who has been in restraints is now calm. He apologizes to the nurse and says, "I hope I didn't hurt anyone." The nurse's best response is: A. "This is our job. We know how to handle violent clients." B. "We understand you were out of control and didn't;t really mean to hurt anyone." C. "It is fortunate that no one was hurt. You will not be placed in restraints as long as you can control your behavior." D. "It is an unpleasant situation to have to restrain someone, but we have to think of the other clients. We can't have you causing injury to others. I just hope it won't happen again."

C

A client with OCD says to the nurse, "I've been here 4 days now, and I'm feeling better. I feel comfortable on this unit, and I'm not ill-at-ease with the staff or other patients anymore." In light of this change, which nursing intervention is most appropriate? A. Give attention to the ritualistic behaviors each time they occur, and point out their inappropriateness. B. Ignore the ritualistic behaviors, and they will be eliminated for lack of reinforcement. C. Set limits on the amount of time the client may engage in the ritualistic behavior. D. Continue to allow the client all the time she wants to carry out the ritualistic behavior.

C

A competent, voluntary client has states he wants to leave the hospital. The nurse hides his clothes in an effort to keep him from leaving. Which which of the following legal actions might the nurse be charged because of this nursing action? A. Assault B. Battery C. False Imprisionment D. Breach of Confidentiality

C

A hospitalized client with bulimia nervosa has stopped vomiting in the hospital and tells the nurse she is afraid she is going to gain weight. Which is the most appropriate response by the nurse? A. "Don't worry. The dietitian will ensure you don't get too many calories in your diet." B. "Don't worry about your weight. We are going to work on other problems while you are in the hospital." C. "I understand that you are concerned about your weight, and we will talk about the importance of good nutrition, but for now I want you to tell me about your recent invitation to join the National Honor Society. That's quite an accomplishment." D. "You are not fat, and the staff will ensure that you do not gain weight while you are in the hospital, because we know that is important to you."

C

A nurse is assisting an individual with mental illness recovery using the Tidal Model. Which of the following is a component of this model? A. the wellness toolbox. B. The daily maintenance list. C. The individual's personal story. D. Triggers.

C

A nurse who is helping a client with mental illness recovery using the WRAP Model says to the client, "First you must create a wellness toolbox." She explains to the client that a wellness toolbox is which of the following? A. A list of words that describe how the individual feels when he or she is feeling well. B. A list of things the client needs to do every day to maintain wellness. C. A list of strategies the client has used in the past that help relieve disturbing symptoms. D. A list of all the client's favorite healthcare providers and phone numbers.

C

A typewritten report for your psychiatric nursing class is due tomorrow at 8 a.m. The assignment was made 4 weeks ago, and yours is ready to turn in. Your roommate says, "I finally finished writing my report, but now I have to go to work, and I don't have time to type it. Please be a dear and type it for me, otherwise I'll fail!" You have a date with your boyfriend. Which of the following is an example of an aggressive response? A. "Okay, I'll call Ken and cancel our date." B. "I don't want to stay here and type your report. I'm going out with Ken." C. "You've got to be kidding! What kind of a fool do you take me for, anyway?" D. "Okay, I'll do it." However, when your roommate returns from work at midnight, you are asleep and the report has not been typed.

C

Andrew, a New York City firefighter, and his entire unit responded to the terrorist attacks at the World Trade Center. Working as a team, he and his best friend, Carlo, entered the area together. Carlo was killed when the building collapsed. Andrew was injured but survived. Since that time, Andrew has had frequent nightmares and anxiety attacks. He says to the mental health worker, "I don't know why Carlo had to die and I didn't!" This statement by Andrew suggests that he is experiencing: A. Spiritual distress. B. Night terrors. C. Survivor's guilt. D. Suicidal ideation.

C

Anna's dog, Lucky, her pet for 16 years, was killed by a car 3 years ago. Since that time, Anna has lost weight, rarely leaves her home, and talks excessively about Lucky. Why would Anna's behavior be considered maladaptive? A. It has been more than 3 years since Lucky died. B. Her grief is too intense over the loss of a dog. C. Her grief is interfering with her functioning. D. Cultural norms typically do not comprehend grief over the loss of a pet.

C

Anne, age 24, and her husband are seeking treatment at the sex therapy clinic. They have been married for 3 weeks and have never had sexual intercourse together. Pain and vaginal tightness prevent penile entry. Sexual history reveals Anne was raped when she was 15 years old. Which of the following would be most appropriate nursing diagnosis? A. Pain related to vaginal construction. B. Ineffective sexuality patterns related to inability to have vaginal intercourse. C. Sexual dysfunction related to history of sexual trauma. D. Complicated grieving related to loss of self-esteem because of rape.

C

At a hospital committee meeting, a fellow nurse who is the chairperson has interrupted you each time you have tried to make a statement. The next time it happens, you intend to respond assertively. Which of the following is an example of an assertive response? A. "You make a lousy leader! You won't even let me finish what I'm trying to say!" B. You say nothing. C. "Excuse me. I would like to finish my statement." D. You say nothing, but you fail to complete your assignment and do not show up for the next meeting.

C

At a synapse, the determination of further impulse transmission is accomplished by means of which of the following? A. Potassium Ions B. Interneurons C. Neurotransmitters D. The Myelin Sheath

C

Attempting to calm an angry client by using "talk therapy" is an example of which of the following clients' rights? A. The right to privacy. B. The right to refuse medicine. C. The right to least-restrictive treatment alternative. D. The right to confidentiality.

C

B.J. has been out with his friends. He is late getting home. He knows his wife will be angry and will yell at him for being late. He stops at the florist and buys a dozen red roses for her. Which of the following behaviors represents positive reinforcement on the part of the wife? A. She meets him at the door, accepts the roses, and says nothing further about his being late. B. She meets him at the door, yelling that he is late, and makes him spend the night on the couch. C. She meets him at the door, expresses delight with the roses, and kisses him on the cheek. D. she meets him at the door and says, "How could you? You know I am allergic to roses!"

C

Benjamin is a member of an Alcoholics Anonymous group. He learned about the effects of alcohol on the body when a nurse from the chemical dependency unit spoke to the group. This is an example of which therapeutic factor? A. Catharsis. B. Altruism. C. Imparting of information. D. Universality.

C

Dan has been admitted to the alcohol rehabilitation unit after being fired for drinking on the job. Dan's drinking buddies come for a visit, and when they leave, the nurse smells alcohol on Dan's breath. Which of the following would be the best intervention with Dan at this time? A. Search his room for evidence. B. Ask, "Have you been drinking alcohol, Dan." C. Send a urine specimen from Dan to the laboratory for drug screening. D. Tell Dan, "These guys cannot come to the unit to visit you again."

C

Electroconvulsive therapy is most commonly prescribed for which of the following? A. Bipolar Disorder, Manic B. Paranoid Schizophrenia C. Major Depression D. Obsessive-Compulsive Disorder

C

Elena has just received a promotion on her job. She is very happy and excited about moving up in her company, nut she has been experiencing anxiety since receiving the news. Her primary appraisal is that she most likely views the situation as which of the following? A. Benign-positive B. Irrelevant C. Challenging D. Threatening

C

For what reason would Anna's illness be considered a neurosis rather than a psychosis? A. She is unaware that her behavior is maladaptive. B. She exhibits inappropriate affect (emotional tone). . C. She experiences no loss of contact with reality. D. She tells the nurse. "There is nothing wrong with me!"

C

Frank is a Latino American who has an appointment at the community health center for 1 p.m. The nurse is angry when Frank shows up at 3:30 p.m. stating, "I was visiting with my brother." How must the nurse interpret this behavior? A. Frank is being passive-aggressive by showing up late. B. This is Frank's way of defying authority. C. Frank is a member of a cultural group that is present-time oriented. D. Frank is a member of a cultural group that rejects traditional medicine.

C

Fred rides a crowded subway every day. He stands beside a woman he finds very attractive. Just as the subway is about to stop he places his hand on her breast and rubs his genitals against her buttock. As the door opens, he dashes out and away. Later, he fantasizes she is in love with him. This is an example of which paraphilia? A. Voyeuristic disorder B. Sexual sadism disorder C. Frotteuristic disorder D. Exhibitionistic disorder

C

Gloria, a recent widow, states, "I'm going to have to learn to pay all the bills, Hank always did that. I don't know if I can handle all of that." This is an example of which of the tasks described by Worden? A. Task I: Accepting the reality of loss. B. Task II: Processing the pain of grief. C. Task III: Adjusting to a world without lost entity. D. Task IV: Finding an enduring connection with the lost entity in the midst of embarking on a new life.

C

In evaluating the progress of Jack, a client diagnosed with antisocial personality disorder, which of the following behaviors would be considered the most significant indication of positive changes? A. Jack got angry only once in group this week. B. Jack was able to wait a whole hour for a cigarette without verbally abusing the staff. C. On his own initiative, Jack sent a note of apology to a man he had injured in a recent fight. D. Jack stated that he would no longer start any more fights.

C

In prioritizing care within the therapeutic environment, which of the following nursing interventions would receive the highest priority? A. Ensuring that the physical facilities are conducive to achievement of the goals of therapy. B. Scheduling a community meeting for 8:30 each morning. C. Attending to the nutritional and comfort needs of all clients. D. Establishing contacts with community resources.

C

Initial symptoms of lithium toxicity include: A. Constipation, dry mouth B. Dizziness, thirst C. Vomiting, diarrhea D. Anuria, arrhythias

C

Janet failed her first test in nursing school. She thinks, "Well, that's it! I'll never be a nurse." What automatic thought does this statement represent? A. Overgeneralization B. Magnification C. Catastrophic thinking D. Personalization

C

Jenny reported to the high school nurse that her mother drinks too much. She is drunk every afternoon when Jenny gets home. jenny is afraid to invite friends over because of her mother. What is this type of crisis called: A. Crisis resulting from traumatic stress. B. Maturational/developmental crisis. C. Dispositional crisis. D. Crisis reflecting psychopathology.

C

John, a veteran of the war in Iraq, is diagnosed with PTSD. He experiences a nightmare during his first night in the hospital. He explains to the nurse that he was dreaming about gunfire all around and people being killed. The nurse's most appropriate initial intervention is to: A. Administer alprazolam as ordered pro for anxiety. B. Call the physician and report the incident. C. Stay with John and reassurance him of safety. D. Have John listen to a tape of relaxation exercises.

C

John, who was hospitalized with alcohol intoxication and violent behavior, is sitting in the dayroom watching TV with the other clients when the nurse approaches with his 5 p.m. dose of haloperidol. John says, "I feel in control now. I don't need any drugs." The nurse's best response id based on which of the following statements? A. John must have the medication, or he will become violent. B. John knows that if he will not take the medication orally, he will be restrained and given an intramuscular injection. C. John has the right to refuse the medication provided there is no immediate danger to self or others. D. John must take the medication at this time in order to maintain adequate blood levels.

C

Joselyn is a new patient at the mental health clinic. She has been diagnosed with body dysmorphic disorder. Which of the following medications is the psychiatric nurse practitioner most likely to prescribe for Joselyn? A. Alprazolam (Xanex) B. Diazepam (Valium) C. Fluoxetine (Prozac) D. Olanzapine (Zyprexa)

C

Juan, a veteran of the war in Iraq, has been diagnosed with PTSD. He has been hospitalized on the psychiatric unit following attempted suicide. In the middle of the night, he wakes up yelling and tells the nurse he was having a flashback to when his unit transport drove over an improvised explosive device (IED) and most of his fellow soldiers were killed. He is breathing heavily , perspiring, and his heart is pounding, The nurse's most appropriate initial intervention is which of the following? A. Contact the doctor on call to report the incident. B. Administer the pro order for chlorpromazine. C. Stay with Juan and reassure him of his safety. D. Have Juan sit outside the nurses' station until he is calm.

C

Judy has been in the hospital for 3 weeks. she has used Valium "to settle my nerves" for the past 15 years. She was admitted by her psychiatrist for safe withdrawal from the drug. She has passed the physical symptoms of withdrawal at this time, but states to the nurse "I don't know if I will make it without Valium after I go home. I'm already starting to feel nervous. I have so many personal problems." Which of the following is the most appropriate response by the nurse? A. "Why do you think you have to have drugs to deal with your problems?" B. "Everybody has problems, but not everybody uses drugs to deal with them. You'll just have to do the best that you can." C. "Let's explore some things you can do to decrease your anxiety without resorting to drugs." D. "Just hang in there. I'm sure everything is going to be okay."

C

Lorraine, a client diagnosed with somatic symptom disorder, tells the nurse about a pain in her side. She says she had not experienced it before. Which is the most appropriate response by the nurse? A. "I dont want to hear about another physical complaint. you know they are all in your head. It's time for group therapy now." B. "Let's dit down here together and you can tell me about this new pain you are experiencing. You'll just have to miss group therapy today." C. "I will report this pain to your physician. In the meantime, group therapy is in 5 minutes." D. "I will call your physician and see if he will order a new pain medication for your side. The one you have now doesn't seem to provide relief. Why don't you get some rest for now?"

C

Lucky sometimes refused to obey Anna's commands to come back to her, including when he ran into the street on the day of the accident. But Anna continues to insist, "He was the very best dog. He always minded me. He always did everything i told him to do." Which defense mechanism is Anna exhibiting? A. Sublimation B. Compensation C. Reaction formation D. Undong

C

Margaret, age 68, is diagnosed with bipolar disorder, current episode manic. She is extremely hyperactive and has lost weight. One way to promote adequate nutritional intake for Margaret is to: A. Sit with her during meals to ensure that she eats everything on her tray. B. Have her sister-in-law bring all her food from home because she knows Margaret's likes and dislikes. C. Provide high-calorie, nutritious finger foods and snacks that Margaret can eat "on the run." D. Tell Margaret that she will be on room restriction until she starts gaining weight.

C

Mike was injured during combat in Afghanistan. He has a diagnosis of TBI. Which of the following medications night the physician prescribe to improve Mike's memory and thinking capability? A. Carbamazepine B. Duloxetine C. Donepezil D. Bupropion

C

Miss Lee is an Asian American on the psychiatric unit. She tells the nurse, "I must have the hot ginger root for my headache. It is the only thing that will help." What cultural belief is likely associated with Miss Lee's request? A. She is being obstinate and wants control over her care. B. She believes that ginger root has magical qualities. C. She subscribes to the restoration of health through the balance of yin and yang. D. Asian Americans refuse to take traditional medicine for pain.

C

Mr. and Mrs. Jones have been married for 21 years. Mr. Jones is the family breadwinner, and Mrs. Jones has ever worked outside the home. Mr. Jones has always made all the decisions for the family, and Mrs. Jones has always been compliant. According to the strategic model of family therapy, this is an example of which of the following? A. Marital schism. B. Pseudomutuality. C. Marital skew. D. Pseudohostility.

C

Nancy, who is dying of cancer, says to the nurse, "I just want to see my new grandbaby. If only God will let me live until she is born, then I'll be ready to go." This is an example of which Kubler-Ross's stages of grief? A. Denial B. Anger C. Bargaining D.Acceptance

C

Nina has been hospitalized with adjustment disorder with depressed mood following the breakup of her marriage. Which of the following is true regarding the diagnosis of adjustment disorder? A. Nina will require long-term psychotherapy to achieve relief. B. Nina likely inherited a genetic tendency for the disorder. C. Nina's symptoms will likely remit once she has accepted the change in her life. D. Nina probably would not have experienced adjustment disorder if she had a higher level of intelligence.

C

Nurse Carol is the leader of a bereavement group for widows. Elena is a new member who listens to the group and learns that Jane has been a widow for 5 years now. Jane has adjusted well and Elena thinks maybe she can too. Nurse Carol appropriately identifies this as evidence of which therapeutic factor? A. Universality. B. Imitative behavior. C. Installation of hope. D. Imparting of information.

C

Nurse Mary has been providing care for Tom during his hospital stay. On Tom's day of discharge, his wife brings a bouquet of flowers and box of chocolates to his room. He presents these gifts to Nurse Mary, saying "Thank you for taking care of me." What is a correct response by the nurse? A. I don't accept gifts from patients. B. Thank you so much! It is so nice to be appreciated. C. Thank you. I will share these with the rest of the staff. D. Hospital Policy forbids me to accept gifts from patients.

C

Nursing diagnoses are prioritized according to which of the following? A. Degree of potential for resolution. B. Legal implications associated with nursing intervention. C. Life-threatening potential. D. Client and family requests.

C

Opal is a 43-year-old woman who is suffering from depression and suicidal ideation. Opal says, "I'm such a worthless person. I don't deserve to live." This therapist responds, "I would like for you to think about what problems committing suicide would solve." The therapist is using which of the following cognitive therapy techniques? A. Imagery B. Role Play C. Problem-Solving D. Thought Recording

C

Sam, who has been hospitalized for ECT treatments, says to the nurse on admission. "I don't want to end up like McMurphy in One Flew Over the Cuckoo's Nest! I'm scared!" Which of the following statements would be most appropriate by the nurse in response to Sam's expression of concern? A. "I guarantee you won't end up like McMurphy, Sam." B. "The doctor knows what he is doing, There's nothing to worry about." C. "I know you are scared, Sam, and we're going to talk about what you can expect from the therapy." D. "I'm going to stay with you as long as you are scared."

C

Some obese individuals take amphetamines to suppress appetite and help them lose weight. Which of the following adverse effect association with the use of amphetamines that makes this practice undesirable? A. Bradycardia B. Amenorrhea C. Tolerance D. Convulsions

C

Succinylcholine is administered to a client receiving ECT for what purpose? A. To alleviate anxiety. B. To decrease secretions. C. To relax muscles. D. As a short-acting anesthetic.

C

Symptoms of alcohol withdrawal include: A. Euphoria, hyperactivity, and insomnia. B. Depression, suicidal ideation, and hypersomnia. C. Diaphoresis, nausea and vomiting, and tremors. D. Unsteady gait, nystagmus, and profound disorientation.

C

Tam has a new diagnosis of panic disorder. Dr. S has written a prn order for alprazolam (Xanax) for when Tam is feeling anxious. She says to the nurse, " Dr. S prescribed busprione for my friend's anxiety. Why did he order something different for me?" The nurse's answer is biased on which of the following? A. Buspirone is not an anti-anxiety medication. B. Alaprazolam and buspirone are essentially the same medication, so either one is appropriate. C. Buspirone has delayed onset of action and cannot be used on PRN basis. D. Alprazolam is the only medication that really works for panic disorder.

C

The child with autism spectrum disorder has difficulty with trust. With this in mind, which of the following nursing actions would be most appropriate. A. Encourage all staff to hold the child as often as possible, converting trust through touch. B. Assign a different staff member each day so the child will learn that everyone can be trusted. C. Assign the same staff person as often as possible to promote feelings of security and trust. D. Avoid eye contact because it is extremely uncomfortable for the child and may even discourage trust.

C

The husband says to the wife, "What do you want to do tonight?" and the wife responds, "Whatever you want to do." This is an example of which of the following? A. Extremely rigid boundaries. B. A boundary violation. C. Extremely flexible boundaries. D. Showing respect for the boundary of another.

C

The intermittent exiting and entering of various family members and reestablishing of the bond of the dyadic marital relationship are characteristics associated with which stage of family development? A. The newly married couple. B. The family wit adolescents. C. The family launching grown children. D. The family in later life.

C

The night nurse finds Mrs. G., a client with Alzheimer's disease, wandering the hallway at 4 a.m. and trying to open the door to the side yard. Which statement by the nurse probably reflects the most accurate assessment of the situation? A. "That door leads out to the patio, Mrs. G. It's nighttime. You don't want to go outside now." B. "You look confused, Mrs. G. What is bothering you?" C. "This is the patio door, Mrs. G. Are you looking for the bathroom?" D. "Are you lonely? Perhaps you'd like to go back to your room and talk for a while?"

C

The nurse decides to tell the client of his terminal illness because she believes it is her duty to do so. Which of the following ethical theories is considered in this decision? A. Natural law theories. B. Ethical egoism C. Kanianism D. Utilitarianism

C

The nurse is caring for a client with schizophrenia. Orders from the physician include 100mg chlorpromazine IM STAT and then 50mg PO bid; 2mg benztriopine OP bid pro. Why is chlorpromazine ordered? A. To reduce extrapyramidal symptoms. B. To prevent neuroleptic malignant syndrome. C. To decrease psychotic symptoms. D. To induce sleep.

C

The nurse is interviewing a client on the psychiatric unit. The client tilts his head to the side, stops talking in midsentence, and listens intently. The nurse recognizes from the signs that the client is likely experiencing: A. Somatic delusions. B. Catatonic stupor. C. Auditory hallucinations. D. Pseudoparkinsonism

C

The nurse is using nursing process to care for a client who is suicidal. Which of the following nursing actions is a part of the implementation step of the nursing process? A. Prioritizes the necessity for maintaining a safe environment for the client. B. Determines if nursing interventions have been appropriate to achieve desired results. C. Collaborates with the client to develop a plan for ongoing safety and suicide prevention. D. Establishes goal of care: Client will not harm self during hospitalization.

C

The nurse leader is explaining about group "therapeutic factors" to members of the group. She tells the group that group situations are beneficial because members can see that they are not alone in their experiences. Nurse Carol appropriately identifies this as evidence of which therapeutic factor? A. Altruism. B. Imitative behavior. C. Universality. D. Imparting of information.

C

The nursing history and assessment of an adolescent with a conduct disorder might reveal all of the following behaviors except: A. Manipulation of others for fulfillment of own desires. B. Chronic violation of rules. C. Feelings of guilt associated with the exploitation of others. D. Inability to form close peer relationships.

C

The psychiatric nurse encourages Amanda (client in question 3) to express her anger. Why is this an appropriate nursing intervention? A. Anger is the basis for self-esteem problems. B. The nurse suspects that Amanda was abused as a child. C. The nurse is attempting to guide Amanda through the grief process. D. The nurse recognizes that Amanda has long-standing repressed anger.

C

The therapist teaches a client that when the idea of herself as a worthless person starts to form in her mind, she should immediately start to whistle the tune of "Dixie." What cognitive therapy technique is the therapist using? A. Behavioral Rehearsal B. Social Skills Training C. Distraction D. Generating Alternatives.

C

Theresa is hospitalized following a suicide attempt after breaking up with her boyfriend. Theresa says to the nurse, "When I get out of here, I'm going to try this again, and next time I'll choose a no-fail method." Which is the best response by the nurse? A. "You are safe here. We will make sure nothing happens to you." B."You're just lucky your roommate came home when she did." C. "What exactly do you plan to do?" D. "I don't understand. You have so much to live for."

C

Theresa, age 27, was admitted to the psychiatric unit from the medical intensive care unit where she was treated for taking deliberate overdose of her antidepressant medication, trazodone (Desyrel). She says to the nurse, "My boyfriend broke up with me. We had been together for six years. I love him so much. I know I'll never get over him." Which is the best response by the nurse? A. "You'll get over him in time, Theresa." B. "Forget him. There are other fish in the sea." C. "You must be feeling very sad about your loss." D. "Why do you think he broke up with you, Theresa?"

C

Using Bowen's systems approach with a family in therapy, the therapist would: A. Try to change family principles that may be promoting dysfunctional behavior patterns. B. Strive to create change in destructive behavior through improvement in communication and interaction patterns. C. Encourage increase in the differentiation of individual family members. D. Promote change in dysfunctional behavior by encouraging the formation of more diffuse boundaries between family members.

C

When a client suddenly becomes aggressive and violent on the unit, which of the following approaches would be best for the nurse to use first? A. Provide large motor activities to release the client's pent-up tension. B. Administer a dose of pro chlorpromazine to keep the client calm. C. Call for sufficient help to control the situation safely. D. Convey to the client that his behavior is unacceptable and will not be permitted.

C

When has it been assessed that a client is in control and no longer requires restraining, how does the nurse proceed? A. The nurse removes the restraints. B. The nurse calls for assistance to remove the restraints. C. With assistance, the nurse removes one restraint. D. The nurse tells the client he will have to wait until the doctor comes in.

C

When there is congruence between what is felt and what is expressed, the nurse is exhibiting which of the following characteristics? A. Trust B. Respect C. Genuineness D. Empathy

C

Which grief reaction can the nurse anticipate in a 10-year-old child? A. Statements that the deceased person will return. B. Regressive behaviors, such as loss of bladder control. C. A preoccupation with the loss. D. Thinking that they may have done something to cause the death.

C

Which of the following activities would be a responsibility of the clinical psychologist member of the IDT? A. Locates halfway house and arranges living conditions for client being discharged from the hospital. B. Manages the therapeutic milieu on a 24-hour basis. C. Administers and evaluates psychological tests that assist in diagnosis. D. Conducts psychotherapy and administers electroconvulsive therapy treatments.

C

Which of the following is NOT true regarding grieving by an adolescent? A. Adolescents may not show their true feelings about the death. B. Adolescents tend to have an immortal attitude. C. Adolescents do not perceive death as inevitable. D. Adolescents may exhibit acting out behaviors as part of their grief.

C

Which of the following is a correct assumption regarding the concept of crisis? A. Crises occur only in individuals with psychopathology. B. The stressful event that precipitates crisis is seldom identifiable. C. A crisis situation contains the potential for psychological growth or deterioration. D. Crises are chronic situations that recur many times during an individual's life.

C

Which of the following is a desired outcome of working with an individual who has witnessed a traumatic event and is now experiencing panic anxiety? A. The individual will experience no anxiety. B. The individual will demonstrate hope for the future. C. The individual will identify that anxiety is at a manageable level. D. The individual will verbalize acceptance of self as worthy.

C

Which of the following is the most appropriate therapy for a client with agoraphobia? A. 10 mg Valium qid. B. Group therapy with other agoraphobics. C. Facing the fear in gradual step progression. D. Hypnosis.

C

Which of the following parts of the brain deals with sensory perception and interpretation? A. Hypothalamus B. Cerebellum C. Parietal Lobe D. Hippocampus

C

Which of the following physical manifestations would you expect to assess in a client suffering from anorexia nervosa? A. Tachycardia, hypertension, hyperthermia B. Bradycardia, hypertension, hyperthermia C. Bradycardia, hypotension, hypothermia D. Tachycardia, hypotension, hypothermia

C

Your husband says, "You're crazy to think about going to college! You're not smart enough to handle the studies and the housework, too." Which of the following is an example of a nonassertive response? A. "I will do what I can, and the best that I can." B. (Thinking to yourself): "We'll see how he likes cooking dinner for a change." C. "You're probably right. Maybe I should reconsider." D. "I'm going to do what I want to do, when I want to do it, and you can't stop me!"

C

Which of the following interventions is most appropriate in helping a client with Alzheimer's disease with her ADLs? (SATA) A. Preform ADLs for her while she is in the hospital. B. Provide her with a written list of activities she is expected to perform. C. Assist her with step-by-step instructions. D. Tell her that if her morning care is not completed by 9 a.m., it will be performed for her by the nurse's aide so that she can attend group therapy. E. Encourage her and give her plenty of time to perform independently as many of her ADLs as possible.

C, E

An example of a treatable (reversible) form of NCD is one that is caused by which of the following? (SATA) A. Multiple Sclerosis B. Huntington's Disease C. Electrolyte Imbalance D. HIV Disease E. Folate Deficiency

C,E

A nurse is assisting an individual with mental illness recovery using the Psychological Recovery Model. the client says to the nurse, "I have Schizophrenia. Nothing can be done. I might as well die." In which stage of the Psychological Recovery Model would the nurse assess this individual to be? A. The awareness stage. B. The preparation stage. C. The rebuilding stage. D. The moratorium stage.

D

According to Margaret Mahler, predisposition to BPD occurs when developmental tasks go unfulfilled in which of the following phases? A. Autistic phase, during which the child's needs for security and comfort go unfulfilled. B. Symbiotic phase, during which the child fails to bond with the mother. C. Differentiation phase, during which the child fails to recognize a separateness between self and mother. D. Rapprochement phase, during which the mother withdraws emotional support in response to the child's increasing independence.

D

Aisha is a psychiatric nurse who has been selected to lead a group for women who desire to lose weight. The criterion for membership is that they must be at least 20 pounds overweight. All have tried to lose weight on their own many times in the past without success. At their first meeting, Aisha provides suggestions as the members determine what their goals will be and how they plan to go about achieving those goals. They decided how often they wanted to meet and what they planned to do at each meeting. Which type of group and style of leadership is described in this situation? A. Task group, autocratic leadership. B. Teaching group, democratic leadership. C. Self-help group, laissez-faire leadership. D. Supportive-therapeutic group, democratic leadership.

D

Amanda tried out for the cheerleading squad in junior high but was rejected. At age 15, she had looked forward to trying out for the cheerleading squad in high school. She took cheerleading classes and practiced for many hours every day. However, when tryouts were held, she was not selected. She has become despondent, and her mother takes her to the mental health clinic for counseling. Amanda tells the nurse, "What's the use of trying? I'm not good at anything!" Which of the following nursing interventions is best for Amanda's specific problem? A. Encourage Amanda to talk about her feeling of shame over the second failure. B. Assist Amanda to problem-solve her reasons for not making the team. C. Help Amanda understand the importance of good self-care and personal hygiene in the maintenance of self-esteem. D. Explore with Amanda her past successes and accomplishments.

D

An individual who is addicted to heroin is likely to experience which of the following symptoms of withdrawal? a. Increased heart rate and blood pressure. B. Tremors, insomnia, and seizures C. Incoordination and unsteady gait. D. Nausea and vomiting, diarrhea, and diaphoresis.

D

Anna stated that Lucky was her closest friend, and since his death, there is no one who could ever replace the relationship they had. According to Maslow's hierarchy of needs, which level of need is not being met? A. Physiological needs. B. Self-esteem needs. C. Safety and security needs. D. Love and belonging needs.

D

Anna's daughter notices that Anna appears to be listening to another voice when just the two of them are in a room together. When questioned, Anna admits that she hears someone telling her that she was a horrible caretaker for Lucky and did not deserve to ever have a pet. Which of the following best describes what Anna is experiencing? A. Neurosis B. Psychosis C. Depression D. Bereavement

D

As a child, Joe was physically abused by his father. The father is now dying and has expressed a desire to see his son before he dies. Joe is depressed and says to the mental health nurse, "I'm so angry! Why did God have to give me a father like this? I feel cheated of a father! I've always been a good person. I deserved better. I hate God!" From this subjective data, which nursing diagnosis might the nurse apply to Joe? a. Readiness for enhanced religiosity. b. Risk for impaired religiosity. c. Readiness for enhanced spiritual well-being. d. Spiritual distress.

D

Bill, who has been diagnosed with schizophrenia and has been medication for several months, states, "I'm not taking that stupid medication anymore." Which of the following responses by the nurse demonstrates a motivational interviewing style of communication? A. "Don't you know that if you don't take your medication you will never recover?" B. "Why won't you cooperate with the treatment your doctor prescribed?" C. "Bill, the medication is not stupid." D. "Tell me more about why you don't want to take the medication."

D

Brandon, a client on the psychiatric unit, has been diagnosed with schizophrenia. He begins to tell the nurse about how the CIA is looking for him and will kill him if they find him. The most appropriate response by the nurse is: A. "That's ridiculous, Brandon. No one is going to hurt you." B. "The CIA isn't interested in people like you, Brandon." C. "Why do you think the CIA wants to kill you?" D. "I know you believe that, Brandon, but it's really hard for me to believe."

D

Certain family dynamics often predispose adolescents to the development of conduct disorder. Which of the following patterns is thought to be a contributing factor? A. Parents who are overprotective. B. Parents who have high expectations of their children. C. Parents who constantly set limits on their children's behavior. D. Parents who are alcohol dependent.

D

Cindy regularly develops nausea and vomiting when she is faced with a stressful situation. Which of the following is most likely a predisposing factor to this maladaptive response by Cindy? A. Cindy inherited her mother's "Nervous" stomach. B. Cindy is fixed in a lower level of development. C. Cindy has never been motivated to achieve success. D. When Cindy was a child, her mother pampered her and kept her home from school when she was ill.

D

Client teaching is an important nursing function in milieu therapy. Which of the following statements by the client indicates the need for knowledge and a readiness to learn? A. "Get away from me with that medicine! I'm not sick!" B. "I don't need psychiatric treatment. It's my migraine headaches that I need help with." C. "I've taken Valium every day of my life for the last 20 years. I'll stop when I'm good and ready!" D. "The doctor says I have bipolar disorder. What does that really mean?"

D

Crises occur when an individual: A. Is exposed to a precipitating stressor. B. Perceives a stressor to be threatening. C. Has no support systems. D. Experiences a stressor and perceives coping strategies to be ineffective.

D

Dorothy was involved in an automobile accident while under the influence of alcohol. She swerved her car into a tree and narrowly missed hitting a child on a bicycle. She is in the hospital with multiple abrasions and contusions. She is talking about the accident with the nurse. Which of the following statements by the nurse is most appropriate? A. "Now that you know what can happen when you drink and drive, I'm sure you won't let it happen again." B. "You know that was a terrible thing you did. That child could have been killed." C. "I'm sure everything is going to be okay now that you understand the possible consequences of such behavior." D. "How are you feeling about what happened?"

D

Education for the client who is taking MAOI's should include which of the following? A. Fluid and sodium replacement when appropriate, frequent drug blood levels, signs and symptoms of toxicity. B. Lifetime of continuous use, possible tardive dyskinesia, advantages of an injection every 2 to 4 weeks. C. Short-term use, possible tolerance to beneficial effects, careful tapering of the frug at end of treatment. D. Tyramine-restricted diet, prohibitive concurrent use of over-the-counter medications without physician notification.

D

Ellen has a history of childhood physical and sexual abuse. she was diagnosed with dissociative identity disorder 6 years ago and has been admitted to the psychiatric unit following a suicide attempt. What is the primary nursing diagnosis for Ellen? A. Disturbed personal identity related to childhood abuse. B. Disturbed sensory perception related to repressed anxiety. C. Impaired memory related to disturbed thought process. D. Risk for suicide related to unresolved grief.

D

Emma, a nurse in a family medicine outpatient clinic, conducts initial interviews when new families are referred. She has just finished interviewing a mother who has come to the clinic with her three children, ages 5, 7, and 11. The mother says to the oldest child, "You have been such a help to me, playing with your brothers while I talk to the nurse." In assessing family interaction, the nurse recognizes this statement as a direct indicator of which of the following? A. Family climate. B. Family members' expectations. C. Handling differences. D. Self-concept reinforcement.

D

Emma, age 16, has recently been diagnosed with diabetes mellitus. She must watch her diet and take an oral hypoglycemic medication daily. She has become very depressed, and her mother reports that Emma refuses to change her diet and often skips her medication. Emma has been hospitalized for stabilization of her blood sugar. The psychiatric nurse practitioner has been called in as a consult. Which of the following nursing diagnoses by the psychiatric nurse would be a priority for Emma at this time? A. Anxiety related to hospitalization evidenced by noncompliance. B. Low self-esteem related to feeling different from her peers evidenced by social isolation. C. Risk for suicide related to a new diagnosis of diabetes mellitus. D. Risk-prone health behavior related to denial of the seriousness of her illness evidenced by refusal to follow diet and take medication.

D

Engel identifies which of the following as successful resolution of the grief process? A. When the bereaved person can talk about the loss without crying. B. When the bereaved person no longer talks about the lost entity. C. When the bereaved person puts all remembrances of the loss out of sight. D. When the bereaved person can discuss both positive and negative aspects about the lost entity.

D

Fourteen-year-old Sally has been spending many hours after school watching TV. She has virtually stopped practicing her piano lessons. Sally's parents ask for advice about how to encourage Sally to practice more. The nurse believes on the Premack principle may be helpful. Which of the following does she suggest to Sally's parents? A.She tells Sally's parents to reward Sally each time she practices piano, even if it is only for 5 minutes. B. She tells Sally's parents to ignore this behavior and eventually she will start practicing on her own. C. She tells Sally's parents to draw up a contract with Sally stating what the consequences will be if she does not practice piano. D. She tells Sally's parents to explain to Sally that she may watch TV only after she has practiced the piano for 1 hour.

D

Frank drives his car up to a strange woman, stops, and asks her for directions. As she is explaining, he reveals his erect penis to her. This is an example of which paraphilic disorder? A. Sexual sadism disorder B. Sexual masochism disorder C. Frotteuristic disorder D. Exhibitionistic disorder

D

Ginger, age 19 and only child, left 3 months ago to attend college of her choice 500 miles away from home. It is Ginger's first time away. She has difficulty making decisions and will not undertake anything new without first consulting her mother. They talk on the phone almost every day. Ginger has recently started having anxiety attacks. She consults the nurse practitioner in the student health center. What is this type of crisis called: A. Crisis resulting from traumatic stress. B. Dispositional crisis. C. Psychiatric emergency. D. Maturational/developmental crisis.

D

Hildegard Peplau identified seven subroles within the role of the nurse. She believed the emphasis in psychiatric nursing was on which of the subroles? A. The resource person. B. The teacher. C. The surrogate. D. The counselor.

D

Jack and Ann have come to the clinic for family therapy. They have been married for 18 years. Jack had an affair with his secretary 5 years ago. He fired the secretary and assures Ann and the nurse that he has been faithful ever since. Jack tells the nurse, "We have never been able to get along with each other. We can't talk about anything- all we do is shout at each other. And every time she gets angry with me, she brings up my infidelity. I can't even imagine how many times each of us has threatened divorce over the years. Our kids don't have any idea what it is like to have parents who get along with each other. I've really had enough!" The nurse would most likely document which of the following in her assessment on this couple? A. Marital skew. B. Pseudohostility. C. Double-bind communication. D. Marital schism.

D

Jessica is a nurse who was floated to the psychiatric unit to cover for a staff nurse who called out sick. She encounters a patient diagnosed with BPD, and the patient states, "thank goodness they sent you to the unit. No one else here has taken the time to listen to my concerns." This may be an example of which symptom common in BPD? A. Impulsivity B. Self-harming behaviors C. Dissociation D. Splitting

D

Joe has been in rehabilitation for alcohol dependence. When he returns from a visit to his home, he tells the nurse, "We were having a celebration and I did have one drink, but it really wasn't a problem." The nurse notices that his breath smells of alcohol. Which of the following responses by the nurse demonstrates a motivational interviewing style of communication? A. "You are obviously not motivated to change, so perhaps we should discuss your discharge from the treatment program." B. You need to abstain from alcohol in order to recover, so let me talk to the doctor about the consequences of your behavior." C. "Why would you destroy everything you've worked so hard to achieve?" D. "What do you mean when you say, "It really wasn't a problem?"

D

Joe is very restless and is pacing the room. The nurse says to Joe, "If you don't sit down in the chair and be still, I'm going to put you in restraints!" Which which of the following legal actions might the nurse be charged because of this nursing action? A. Defamation of Character B. Battery C. Breach of Confidentiality D. Assault

D

Joe, an American Indian, goes to the ED because he has an oozing stasis ulcer on his leg. He is accompanied by the tribal shaman, who has been treating Joe on the reservation. As a greeting, the physician extends his hand to the shaman, who lightly touches the physician's hand then quickly moves away. What cultural norm among American Indians most likely explains the shaman's behavior? A. The shaman is snubbing the physician. B. The shaman is angry at Joe for wanting to go to the ED. C. The shaman does not believe in traditional medicine. D. The shaman does not feel comfortable with touch.

D

Karen's counselor asked her if she would like a hug. This is an example of which of the following? A. Rigid boundary. B. A boundary violation. C. Enmeshed boundary. D. Showing respect for the boundary of another.

D

Kim has a diagnosis of borderline personality disorder. She often exhibits alternating clinging and distancing behaviors. The most appropriate nursing intervention with this type of behavior would be to: A. Encourage Kim to establish trust in one staff person, With whom all therapeutic interaction should take place. B. Secure a verbal contract from Kim that she will discontinue these behaviors. C. Withdraw attention of these behaviors continue. D. Rotate staff members who work with Kim so that she will learn to relate to more than one person.

D

Lucille has a diagnosis of illness anxiety disorder. Which of the following symptoms would be consistent with this diagnosis? A. Complains of a multitude of incapacitating physical symptoms,. B. Manifests with pseudoseizures or pseudocyesis. C. Takes substances to induce vomiting in order to convince the nurse that she needs treatment. D. Expresses persistent fears of having a life-threatening disease. E. All of the above.

D

Lucky's accident occurred when he got away from Anna while they were taking a walk. He ran into the street and was hit by a car. Anna cannot remember the circumstances of his death. This is an example of what defense mechanism? A. Rationalization B. Suppression C. Denial D. Repression

D

Miss Lee, an Asian American on the psychiatric unit, says she is afraid that no one from her family will visit her. On what belief does Miss Lee base her statement? A. Many Asian Americans do not believe in hospitals. B. Many Asian Americans do not have close family support systems. C. Many Asian Americans believe the body will heal itself if left alone. D. Many Asian Americans view psychiatric problems as bringing shame to the family.

D

Mrs. G. has been diagnosed with NCD due to Alzheimer's disease. The cause of this disorder is which of the following? A. Multiple small brain infarcts. B. Chronic alcohol abuse. C. Cerebral abscess. D. Unknown

D

Mrs. G., who has NCD due to Alzheimer's disease, has trouble sleeping and wanders around at night. Which of the following nursing actions would be best to promote sleep in Mrs. G.? A. Ask the doctor to prescribe flurazepam (Dalmane). B. Ensure that Mrs. G. gets and afternoon nap so she will not be overtired at bedtime. C. Make Mrs. G. a cup of tea with honey before bedtime. D. Ensure that Mrs. G. gets regular physical exercise during the day.

D

Ms. T. has been diagnosed with agoraphobia. Which behavior would be most characteristic of this disorder? A. Ms. T. experiences panic anxiety when she encounters snakes. B. Ms. T. refuses to fly on an airplane. C. Ms. T. will not eat in a public place. D. Ms. T. stays in her home for fear of being in a place from which she cannot escape.

D

Nancy's new in-laws came to dinner for the first time. When Nancy's mother-in-law left some food on her plate, Nancy thought, "I must be a lousy cook." What automatic thought does this statement represent? A. Dichotomous Thinking B. Overgeneralization C. Minimization D. Personalization

D

Nurse Jones is working with Kim, a client in the anger-management program. Which of the following identifies actions associated with the working phase of the therapeutic relationship? A. Kim tells Nurse Jones she wants to learn more adaptive ways to handle her anger. Together, they set some goals. B. The goals of therapy have been met, but Kim cries and says she has to keep coming to the therapy in order to be able to handle her anger appropriately. C. Nurse Jones reads Kim's previous medical records. She explores her feelings about working with a woman who has abused her child. D. Nurse Jones helps Kim practice various techniques to control her angry outbursts. She gives Kim positive feedback for attempting to improve maladaptive behavior.

D

Nursing care for a client with somatic symptom disorder would focus on helping her to: A. Eliminate the stress of her life. B. Discontinue her numerous physical complaints. C. Take her medication only as prescribed. D. Learn more adaptive coping strategies.

D

Paul is the member of an anger management group. He knew that people did not want to be his friend because of his violent temper. In the group, he has learned to control his temper and form satisfactory interpersonal relationships with others. This is an example of which therapeutic factor. A. Catharsis. B. Altruism. C. Imparting of information. D. Development of socializing techniques.

D

S.T. is a 15-year-old girl who has just been admitted to the adolescent psychiatric unit with a diagnosis of anorexia nervosa. She is 5 feet 5 inches tall and weighs 82 lb. She was elected to the cheerleading squad for the fall but states that she is not as good as the others on the squad. The treatment team has identified the following problems: refusal to eat, occasional purging, refusing to interact with staff and peers, and fear of failure. Which of the following nursing diagnoses would be the priority diagnosis for S.T.? A. Social Isolation. B. Disturbed Body Image. C. Low Self-Esteem. D. Imbalanced Nutrition: Less than body requirements.

D

Sandra is the nurse leader of a supportive therapeutic group for individuals with anxiety disorders. On the first day the group meets, Valerie speaks first and begins by sharing the intimate details of her incestuous relationship with her father. What type of member role is Valerie assuming in this group? A. Aggressor. B. Monopolizer. C. Blocker. D. Seducer.

D

The daily record of dysfunctional thoughts (DRDT) is used in cognitive therapy to help clients: A. Identify automatic thoughts. B. Modify automatic thoughts. C. Identify rational alternatives. D. All of the above.

D

The most appropriate nursing intervention with Marie (from question 9) would be to: A. Refer her to her family physician for a complete physical examination. B. Suggest she seek outside employment now that her children have left home. C. Identify convenient support systems for times when she is feeling particularly despondent. D. Begin grief work and assist her to recognize areas of self-worth separate and apart from her children.

D

The most common side effects of ECT are: A. Permanent memory loss and brain damage. B. Fractured and dislocated bones C. Myocardial infarction and cardiac arrest. D. Temporary memory loss and confusion.

D

The nurse is caring for a client with schizophrenia. Orders from the physician include 100mg chlorpromazine IM STAT and then 50mg PO bid; 2mg benztropine PO bid prn. Because benzotropine was ordered on a pro basis, which of the following assessments by the nurse would convey a need for this medication? A. The client's level of agitation increases. B. The client complains of a sore throat. C. The client's skin has a yellowish cast. D. The client develops muscle spasms.

D

The nurse is using nursing process to care for a client who is suicidal. Which of the following nursing actions is a part of the outcome identification step of the nursing process? A. Prioritizes the necessity for maintaining a safe environment for the client. B. Determines if nursing interventions have been appropriate to achieve desired results. C. Obtains a short-term contract from the client to seek out staff if feeling suicidal. D. Establishes goal of care: Client will not harm self during hospitalization.

D

The primary focus of family therapy for clients with schizophrenia and their families is: A. To discuss concrete problem-solving and adaptive behaviors for coping with stress. B. To introduce the family to others with the same problem. C. To keep the client and family in touch with the health-care system. D. To promote family interaction and increase understanding the illness.

D

Theresa is hospitalized following a suicide attempt after breaking up with her boyfriend. The freudian psychoanalytic theory would explain Theresa's suicide attempt in which of the following ways? A. She feels hopeless about her future without her boyfriend. B. Without her boyfriend, she feels like an outsider with her skills. C. She is feeling intense guilt because her boyfriend broke up with her. D. She is angry at her boyfriend for breaking up with her and has turned the anger inward on herself.

D

Walter is angry with his psychiatrist and says to the nurse, "He doesn't know what he is doing. That medication isn't helping a thing!" The nurse responds, "He has been a doctor for many years and has helped many people." This is an example of what nontherapeutic technique? A. Rejecting B. Disapproving C. Probing D. Defending

D

What is the most common comorbid condition in children with bipolar disorder? A. Schizophrenia B. Substance disorders C. Oppositional defiant disorder D. Attention-deficit/hyperactivity disorder

D

What is the priority nursing intervention before starting ECT therapy? A. Take vital signs and record. B. Have the patient void. C. Administer Succinylcholine. D. Ensure that the content form has been signed.

D

Which of the following may be influential in the predisposition PTSD? A. Unsatisfactory parent-child relationship. B. Excess of the neurotransmitter serotonin. C. Distorted, negative cognitions. D. Severity of the stressor and availability of systems.

D

Which of the following parts of the brain has control over the pituitary gland and autonomic nervous system, as well as regulation of appetite and temperature? A. Temporal Lobe B. Parietal Lobe C. Cerebellum D. Hypothalamus

D

Which of the following parts of the brain is associated with multiple feelings and behaviors and is sometimes refered to as the "emotional brain." A. Frontal Lobe B. Thalamus C. Hypothalamus D. Limbic System

D

Which of the following parts of the brain is concerned with visual reception and interpretation? A. Frontal Lobe B. Parietal Lobe C. Temporal Lobe D. Occipital Lobe

D

Which of the following psychosocial therapies has been shown to be helpful for clients with TBI? A. Eye movement desensitization. B. Psychoanalysis C. Reality Therapy. D. Cognitive-behavioral therapy.

D

With implosion therapy, a client with phobic anxiety would be: A. Taught relaxation exercises. B. Subjected to graded intestines of the fear. C. Instructed to stop the therapeutic session as soon as anxiety is experienced. D. Presented with massive exposure to a variety of stimuli association with the phobic object or situation.

D

You are asked to serve on a which you do not wish to serve. Which of the following is an example of a nonassertive response? A. "Thank you, but I don't wish to be a member of that committee." B. "I'll be happy to serve." But then you don't show up for any of the meetings. C. "I'd rather have my teeth pulled!" D. "Okay, if I'm really needed, I'll serve."

D

Intervention with Andrew (from question 15) would include: A. Encouraging expression of feelings. B, Anti-anxiety medications. C. Participation in a support group. D. A and C E. All of the above.

E

Jill has a fear of dogs. In helping her overcome this fear, the therapist is using systematic desensitization. List the following steps in the order in which the therapist would proceed. A. Look at a real dog. B. Look at a stuffed toy dog. C. Pet a real dog. D. Pet the stuffed toy dog. E. Walk past a real dog. F. Look at a picture of a dog.

F, B, D, A, E, C